Provider Demographics
NPI:1790158236
Name:LANCASTER GENERAL MEDICAL GROUP
Entity Type:Organization
Organization Name:LANCASTER GENERAL MEDICAL GROUP
Other - Org Name:PENN MEDICINE LANCASTER GENERAL HEALTH PHYSICIANS NEUROLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT FINANCIAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-544-5010
Mailing Address - Street 1:555 N DUKE ST
Mailing Address - Street 2:NEUROSCIENCE SERVICE LINE ADMINISTRATION
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2250
Mailing Address - Country:US
Mailing Address - Phone:717-396-9167
Mailing Address - Fax:717-396-9064
Practice Address - Street 1:555 N DUKE ST
Practice Address - Street 2:NEUROSCIENCE SERVICE LINE ADMINISTRATION
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2250
Practice Address - Country:US
Practice Address - Phone:717-396-9167
Practice Address - Fax:717-396-9064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-05
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular NeurologyGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty