Provider Demographics
NPI:1760577555
Name:LANCASTER GENERAL HOSPITAL
Entity Type:Organization
Organization Name:LANCASTER GENERAL HOSPITAL
Other - Org Name:JAMES STREET FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:J
Authorized Official - Last Name:BYORICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-544-5511
Mailing Address - Street 1:555 N. DUKE ST.
Mailing Address - Street 2:PO BOX 3555
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602
Mailing Address - Country:US
Mailing Address - Phone:717-544-4950
Mailing Address - Fax:717-544-4149
Practice Address - Street 1:555 N. DUKE ST.
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602
Practice Address - Country:US
Practice Address - Phone:717-544-4950
Practice Address - Fax:717-544-4149
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LANCASTER GENERAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-04
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2061158001OtherAMERIHEALTH 65
PA1518324OtherGATEWAY GROUP#
PA30025858OtherKEYSTONE MERCY
PA172421OtherHEALTH AMERICA
PA100338OtherMERCY GROUP #
PA100771175 0005Medicaid
PA1369108OtherHIGHMARK GROUP#
PA50055923OtherCBC GROUP#
PA000000127890OtherUNISON GROUP#
PA000000134934OtherUNISON - HBP GRP#
PA30025858OtherKEYSTONE MERCY