Provider Demographics
NPI:1891756649
Name:THE HEART GROUP OF LANCASTER GENERAL HEALTH
Entity Type:Organization
Organization Name:THE HEART GROUP OF LANCASTER GENERAL HEALTH
Other - Org Name:THE HEART GROUP OF LGHEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:M
Authorized Official - Last Name:GAYDON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:717-544-8310
Mailing Address - Street 1:217 HARRISBURG AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-2964
Mailing Address - Country:US
Mailing Address - Phone:717-544-8300
Mailing Address - Fax:717-544-8265
Practice Address - Street 1:217 HARRISBURG AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-2964
Practice Address - Country:US
Practice Address - Phone:717-544-8300
Practice Address - Fax:717-544-8265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-31
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Single Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1025233270001Medicaid
PA191201Medicare PIN