Provider Demographics
NPI:1962495747
Name:FRANCIS HENRY HEALTH CENTER, LLC
Entity Type:Organization
Organization Name:FRANCIS HENRY HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:AURELE
Authorized Official - Last Name:WAIT
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:717-482-2035
Mailing Address - Street 1:845 SIR THOMAS CT
Mailing Address - Street 2:SUITE 6
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-4840
Mailing Address - Country:US
Mailing Address - Phone:717-482-2035
Mailing Address - Fax:717-482-2036
Practice Address - Street 1:845 SIR THOMAS CT
Practice Address - Street 2:SUITE 6
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-4840
Practice Address - Country:US
Practice Address - Phone:717-482-2035
Practice Address - Fax:717-482-2036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-26
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD069466L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017838570001Medicaid
PA032244UU7Medicare PIN
PAH05351Medicare UPIN