Provider Demographics
NPI:1972880086
Name:LANCASTER GENERAL HEALTH
Entity Type:Organization
Organization Name:LANCASTER GENERAL HEALTH
Other - Org Name:LANCASTER GENERAL HEALTH INFUSION CENTER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INFUSION CENTER SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:717-544-0404
Mailing Address - Street 1:2102 HARRISBURG PIKE
Mailing Address - Street 2:PO BOX 3200
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2644
Mailing Address - Country:US
Mailing Address - Phone:717-544-0404
Mailing Address - Fax:717-544-0406
Practice Address - Street 1:2102 HARRISBURG PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2644
Practice Address - Country:US
Practice Address - Phone:717-544-0404
Practice Address - Fax:717-544-0406
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LANCASTER GENERAL HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-11-03
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP481972261QX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAI28207Medicare UPIN