Provider Demographics
NPI:1760682199
Name:GRAND VIEW HOSPITAL
Entity Type:Organization
Organization Name:GRAND VIEW HOSPITAL
Other - Org Name:GRAND VIEW HOSPITAL MEDICAL PRACTICES LEDERACH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-453-4120
Mailing Address - Street 1:PO BOX 1111
Mailing Address - Street 2:
Mailing Address - City:HARLEYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19438-0907
Mailing Address - Country:US
Mailing Address - Phone:215-453-4995
Mailing Address - Fax:215-453-4646
Practice Address - Street 1:658 HARLEYSVILLE PIKE
Practice Address - Street 2:SUITE 120
Practice Address - City:HARLEYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19438-2886
Practice Address - Country:US
Practice Address - Phone:215-256-9655
Practice Address - Fax:215-256-9868
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GRAND VIEW HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-24
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1001257410034Medicaid
PA2853950000OtherBLUE SHIELD PERSONAL CHOICE
PA7730556OtherAETNA
PA1972921OtherHIGHMARK BLUE SHIELD
PA2853950001OtherKEYSTONE HEALTH PLAN EAST
PA1001257410034Medicaid