Provider Demographics
NPI:1548384399
Name:LANASTER GENERAL HOSPITAL
Entity Type:Organization
Organization Name:LANASTER GENERAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER REIMBURSEMENT & CREDENTIALI
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:F
Authorized Official - Last Name:WILKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-544-5028
Mailing Address - Street 1:620 N DUKE ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2234
Mailing Address - Country:US
Mailing Address - Phone:717-544-5923
Mailing Address - Fax:
Practice Address - Street 1:620 N DUKE ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2234
Practice Address - Country:US
Practice Address - Phone:717-544-5923
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LANCASTER GENERAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-19
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50055791OtherCAPITAL BLUE CROSS
PA001577508OtherHIGHMARK BLUE SHIELD
PA2258279000OtherAMERIHEALTH 65