Provider Demographics
NPI:1255326120
Name:MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:MEMORIAL HOSPITAL
Other - Org Name:MEMORIAL HOSPITAL ENT CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:IMBIMBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-849-5327
Mailing Address - Street 1:1785 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-2615
Mailing Address - Country:US
Mailing Address - Phone:717-849-5477
Mailing Address - Fax:
Practice Address - Street 1:1785 4TH AVE
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-2615
Practice Address - Country:US
Practice Address - Phone:717-849-5477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-15
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1654968OtherMEM HOSP ENT CLINIC
PA079731Medicare ID - Type UnspecifiedMEM HOSP ENT CLINIC