Provider Demographics
NPI:1376644724
Name:SPRING GROVE FAMILY CARE CENTER LLC
Entity Type:Organization
Organization Name:SPRING GROVE FAMILY CARE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:H
Authorized Official - Last Name:FARRINGTON
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:717-225-6556
Mailing Address - Street 1:2030 THISTLE HILL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SPRING GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17362-1159
Mailing Address - Country:US
Mailing Address - Phone:717-225-6556
Mailing Address - Fax:717-225-0356
Practice Address - Street 1:2030 THISTLE HILL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:SPRING GROVE
Practice Address - State:PA
Practice Address - Zip Code:17362-1159
Practice Address - Country:US
Practice Address - Phone:717-225-6556
Practice Address - Fax:717-225-0356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
63163Medicare ID - Type UnspecifiedGROUP MEDICARE