Provider Demographics
NPI:1508887712
Name:FULTON COUNTY PARTNERSHIP
Entity Type:Organization
Organization Name:FULTON COUNTY PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:DENTAL ASSISTANT
Authorized Official - Phone:717-485-3079
Mailing Address - Street 1:22438 GREAT COVE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MC CONNELLSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17233-8367
Mailing Address - Country:US
Mailing Address - Phone:717-485-3079
Mailing Address - Fax:717-485-4505
Practice Address - Street 1:22438 GREAT COVE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:MC CONNELLSBURG
Practice Address - State:PA
Practice Address - Zip Code:17233-8367
Practice Address - Country:US
Practice Address - Phone:717-485-3079
Practice Address - Fax:717-485-4505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017333900002Medicaid