Provider Demographics
NPI:1538290424
Name:LANCASTER GENERAL HOSPITAL
Entity Type:Organization
Organization Name:LANCASTER GENERAL HOSPITAL
Other - Org Name:SHORT PROCEDURE UNIT
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHARMAINE
Authorized Official - Middle Name:C
Authorized Official - Last Name:ROCHESTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-544-5511
Mailing Address - Street 1:555 N DUKE ST
Mailing Address - Street 2:PO BOX 3555
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2250
Mailing Address - Country:US
Mailing Address - Phone:717-544-5511
Mailing Address - Fax:
Practice Address - Street 1:555 N DUKE ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2250
Practice Address - Country:US
Practice Address - Phone:717-544-5511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100771175 0040Medicaid