Provider Demographics
NPI:1902032709
Name:BATTLEWOUND HEALTHCARE LLC
Entity Type:Organization
Organization Name:BATTLEWOUND HEALTHCARE LLC
Other - Org Name:BATTLEWOUND FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RITA
Authorized Official - Middle Name:B
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-398-2348
Mailing Address - Street 1:1421 CHAMBERSBURG RD
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-8438
Mailing Address - Country:US
Mailing Address - Phone:717-398-2348
Mailing Address - Fax:717-398-2349
Practice Address - Street 1:1421 CHAMBERSBURG RD
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-8438
Practice Address - Country:US
Practice Address - Phone:717-398-2348
Practice Address - Fax:717-398-2349
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BATTLEWOUND FAMILY PRACTICE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-08
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G93299Medicare UPIN