Provider Demographics
NPI:1578689352
Name:SPRINGETTSBURY TOWNSHIP
Entity Type:Organization
Organization Name:SPRINGETTSBURY TOWNSHIP
Other - Org Name:SPRINGETTSBURY TOWNSHIP BOARD OF SUPERVISOR BOS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:HADGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-757-3521
Mailing Address - Street 1:1501 MOUNT ZION ROAD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9084
Mailing Address - Country:US
Mailing Address - Phone:717-757-3521
Mailing Address - Fax:717-718-0837
Practice Address - Street 1:1501 MOUNT ZION ROAD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-9084
Practice Address - Country:US
Practice Address - Phone:717-757-3521
Practice Address - Fax:717-718-0837
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPRINGETTSBURY TOWNSHIP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-22
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA032253416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018416920001Medicaid
PA046353Medicare ID - Type Unspecified