Provider Demographics
NPI: | 1366472706 |
---|---|
Name: | THE GETTYSBURG HOSPITAL |
Entity Type: | Organization |
Organization Name: | THE GETTYSBURG HOSPITAL |
Other - Org Name: | WELLSPAN GETTYSBURG HOSPITAL |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | VP, PRESIDENT THE GETTYSBURG HOSP |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MICHAEL |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | COGLIANO |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 717-337-8324 |
Mailing Address - Street 1: | 785 5TH AVE STE 3 |
Mailing Address - Street 2: | |
Mailing Address - City: | CHAMBERSBURG |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 17201-4232 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 717-263-9555 |
Mailing Address - Fax: | 717-709-6529 |
Practice Address - Street 1: | 147 GETTYS STREET |
Practice Address - Street 2: | |
Practice Address - City: | GETTYSBURG |
Practice Address - State: | PA |
Practice Address - Zip Code: | 17325 |
Practice Address - Country: | US |
Practice Address - Phone: | 717-334-2121 |
Practice Address - Fax: | 717-337-4142 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | THE GETTYSBURG HOSPITAL |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2006-07-03 |
Last Update Date: | 2024-04-04 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
207L00000X, 207P00000X, 207ZP0105X, 367500000X | ||
PA | 01300100 | 207RC0000X, 207RI0200X, 207V00000X, 207ZP0105X, 208000000X, 2083P0901X, 2084P0800X, 208VP0000X, 261QM2500X, 291U00000X, 261QE0002X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261QE0002X | Ambulatory Health Care Facilities | Clinic/Center | Emergency Care | Group - Single Specialty |
No | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | Group - Multi-Specialty | |
Yes | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | Group - Multi-Specialty | |
No | 207ZP0105X | Allopathic & Osteopathic Physicians | Pathology | Clinical Pathology/Laboratory Medicine | Group - Multi-Specialty |
No | 367500000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | Group - Multi-Specialty | |
No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
No | 207RI0200X | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | Group - Single Specialty |
No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Single Specialty | |
No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Single Specialty | |
No | 2083P0901X | Allopathic & Osteopathic Physicians | Preventive Medicine | Public Health & General Preventive Medicine | Group - Single Specialty |
No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Single Specialty |
No | 208VP0000X | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine | Group - Single Specialty |
No | 261QM2500X | Ambulatory Health Care Facilities | Clinic/Center | Medical Specialty | Group - Single Specialty |
No | 291U00000X | Laboratories | Clinical Medical Laboratory | Group - Single Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
PA | 1007590180048 | Medicaid | |
PA | 1384983 | Other | NEUROLOGY PROFESS |
PA | 56471 | Medicaid | |
PA | 56472 | Medicaid | |
PA | CC4974 | Other | RAILROAD MEDICARE |
PA | 1377739 | Other | PATHOLOGY PROFESS |
PW | 1378032 | Other | ANESTHESIA CRNA PROFESS |
PA | 1472553 | Other | ANESTHESIOLOGIST PROFESS |
PA | 1384983 | Other | NEUROLOGY PROFESS |
PA | 56471 | Medicaid |