Provider Demographics
NPI:1508531955
Name:LANCASTER GENERAL MEDICAL GROUP
Entity Type:Organization
Organization Name:LANCASTER GENERAL MEDICAL GROUP
Other - Org Name:PENN MEDICINE LANCASTER GENERAL HEALTH PHYSICIANS PALLIATIVE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT FINANCIAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-544-5010
Mailing Address - Street 1:26 N CEDAR ST # 2084
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-1514
Mailing Address - Country:US
Mailing Address - Phone:717-544-7279
Mailing Address - Fax:717-544-4296
Practice Address - Street 1:609 N CHERRY ST FL 2
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2201
Practice Address - Country:US
Practice Address - Phone:717-544-5070
Practice Address - Fax:717-544-7771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-09
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty