Provider Demographics
NPI:1467401901
Name:WOMEN'S HEALTH CENTER OF LEBANON, LTD
Entity Type:Organization
Organization Name:WOMEN'S HEALTH CENTER OF LEBANON, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TRUDI
Authorized Official - Middle Name:
Authorized Official - Last Name:NOPPENBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-273-8835
Mailing Address - Street 1:300 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17046-4871
Mailing Address - Country:US
Mailing Address - Phone:717-273-8835
Mailing Address - Fax:
Practice Address - Street 1:300 WILLOW ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17046-4871
Practice Address - Country:US
Practice Address - Phone:717-273-8835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
Not Answered207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007740320003Medicaid
1518761OtherGATEWAY HEALTH PLAN
131254OtherHIGHMARK BLUE SHIELD
02480000OtherCAPITAL BLUE CROSS
131254OtherHIGHMARK BLUE SHIELD