Provider Demographics
NPI:1386668952
Name:RUPP, HARRY H
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:H
Last Name:RUPP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 66
Mailing Address - Street 2:
Mailing Address - City:LEMOYNE
Mailing Address - State:PA
Mailing Address - Zip Code:17043-0066
Mailing Address - Country:US
Mailing Address - Phone:717-737-7831
Mailing Address - Fax:717-763-0959
Practice Address - Street 1:722 STATE ST
Practice Address - Street 2:
Practice Address - City:LEMOYNE
Practice Address - State:PA
Practice Address - Zip Code:17043-1536
Practice Address - Country:US
Practice Address - Phone:717-737-7831
Practice Address - Fax:717-763-0959
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0138030001Medicare NSC