Provider Demographics
NPI:1407844897
Name:PATHOLOGY ASSOCIATES OF LANCASTER, PC
Entity Type:Organization
Organization Name:PATHOLOGY ASSOCIATES OF LANCASTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:EISENHOWER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-291-8022
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:1097 COMMERCIAL AVE
Mailing Address - City:EAST PETERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17520-0129
Mailing Address - Country:US
Mailing Address - Phone:586-412-4000
Mailing Address - Fax:586-412-4102
Practice Address - Street 1:250 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-3363
Practice Address - Country:US
Practice Address - Phone:717-291-8022
Practice Address - Fax:717-291-8458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
220003946OtherRAILROAD MEDICARE
PA001122821 0006Medicaid
PA001122821 0009Medicaid
PA001122821 0006Medicaid