Provider Demographics
NPI:1952813453
Name:GREEN HILL FAMILY PRACTICE LLC
Entity Type:Organization
Organization Name:GREEN HILL FAMILY PRACTICE LLC
Other - Org Name:GREEN HILL FAMILY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:GLENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-214-3003
Mailing Address - Street 1:503 BRIDGE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:NEW CUMBERLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17070-1972
Mailing Address - Country:US
Mailing Address - Phone:717-774-8400
Mailing Address - Fax:717-774-8607
Practice Address - Street 1:503 BRIDGE ST STE 200
Practice Address - Street 2:
Practice Address - City:NEW CUMBERLAND
Practice Address - State:PA
Practice Address - Zip Code:17070-1972
Practice Address - Country:US
Practice Address - Phone:717-774-8400
Practice Address - Fax:717-774-8607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-25
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty