Provider Demographics
NPI:1629193016
Name:COMMUNITY CHECK - UP CENTER
Entity Type:Organization
Organization Name:COMMUNITY CHECK - UP CENTER
Other - Org Name:WOMEN'S CHECK-UP CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT OF THE BOARD
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRETCHEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BALLARD
Authorized Official - Suffix:
Authorized Official - Credentials:BSRN
Authorized Official - Phone:717-566-5812
Mailing Address - Street 1:38C HALL MNR
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-3044
Mailing Address - Country:US
Mailing Address - Phone:717-233-1700
Mailing Address - Fax:717-236-8752
Practice Address - Street 1:38C HALL MNR
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104-3044
Practice Address - Country:US
Practice Address - Phone:717-233-1700
Practice Address - Fax:717-236-8752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PANA261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility