Provider Demographics
NPI:1982667424
Name:PEDIATRIC ACUTE CARE SERVICES
Entity Type:Organization
Organization Name:PEDIATRIC ACUTE CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-791-2680
Mailing Address - Street 1:25 W SHORE DR
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-7718
Mailing Address - Country:US
Mailing Address - Phone:717-791-2818
Mailing Address - Fax:
Practice Address - Street 1:2025 TECHNOLOGY PKWY
Practice Address - Street 2:STE 108
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-9400
Practice Address - Country:US
Practice Address - Phone:717-791-2818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA434574OtherHIGHMARK GROUP NUMBER
PA02567200OtherCAIC GROUP NUMBER