Provider Demographics
NPI:1881675445
Name:HERITAGE SURGICAL ASSOCIATES, LTD.
Entity Type:Organization
Organization Name:HERITAGE SURGICAL ASSOCIATES, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:PIEPGRASS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-733-7627
Mailing Address - Street 1:804 GRANDVIEW DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522-1635
Mailing Address - Country:US
Mailing Address - Phone:717-733-2055
Mailing Address - Fax:717-738-4114
Practice Address - Street 1:804 GRANDVIEW DR
Practice Address - Street 2:SUITE 2
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-1635
Practice Address - Country:US
Practice Address - Phone:717-733-2055
Practice Address - Fax:717-738-4114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016835570002Medicaid
PA0000002642Medicare ID - Type Unspecified