Provider Demographics
NPI:1619928074
Name:GGNSC GETTYSBURG LP
Entity Type:Organization
Organization Name:GGNSC GETTYSBURG LP
Other - Org Name:GOLDEN LIVINGCENTER - GETTYSBURG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SEC. OF THE GP
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:RASMUSSEN-JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-201-4835
Mailing Address - Street 1:741 CHAMBERSBURG RD
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-3304
Mailing Address - Country:US
Mailing Address - Phone:717-334-6764
Mailing Address - Fax:717-337-2566
Practice Address - Street 1:741 CHAMBERSBURG RD
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-3304
Practice Address - Country:US
Practice Address - Phone:717-334-6764
Practice Address - Fax:717-337-2566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA132802314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA395247OtherCAPITAL BLUE CROSS
PA101552816Medicaid
PA1015528160001Medicaid
PA1526894OtherGATEWAY HEALTH PLAN
PA000000119194OtherTHREE RIVERS HEALTH PLAN
PA395247OtherCAPITAL BLUE CROSS
PA000000119194OtherTHREE RIVERS HEALTH PLAN