Provider Demographics
NPI:1639190473
Name:LANCASTER GENERAL HOSPITAL
Entity Type:Organization
Organization Name:LANCASTER GENERAL HOSPITAL
Other - Org Name:LANCASTER GENERAL HEALTH PHYSICIANS NEONATOLOGY
Other - Org Type:Other Name
Authorized Official - Title/Position:EVP & CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROEMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-544-4926
Mailing Address - Street 1:PO BOX 3077
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17604-3077
Mailing Address - Country:US
Mailing Address - Phone:717-544-5511
Mailing Address - Fax:
Practice Address - Street 1:690 GOOD DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2433
Practice Address - Country:US
Practice Address - Phone:717-544-5511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LANCASTER GENERAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-21
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA30002739OtherKEYSTONE MERCY
PA001364334OtherHIGHMARK BLUE SHIELD
PA20032074OtherAMERIHEALTH MERCY
PA206143OtherHEALTH AMERICA
PA50056070OtherCAPITAL BLUE CROSS
PA2056500000OtherAMERIHEALTH 65
PA000000126161OtherUNISON