Provider Demographics
NPI:1275734345
Name:MEMORIAL ENTERPRISES INC
Entity Type:Organization
Organization Name:MEMORIAL ENTERPRISES INC
Other - Org Name:MEMORIAL PRIMARY CARE NETWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER OF FINANCE AND CODING
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:NEUBAUER
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:717-815-2557
Mailing Address - Street 1:PO BOX 4844
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17604-4844
Mailing Address - Country:US
Mailing Address - Phone:717-815-2557
Mailing Address - Fax:
Practice Address - Street 1:1232 GREENSPRINGS DR
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-8825
Practice Address - Country:US
Practice Address - Phone:717-755-6166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA039846Medicare ID - Type Unspecified
PA039846Medicare PIN