Provider Demographics
NPI:1023167293
Name:COMMUNITY CHECK-UP CENTER OF SOUTH HARRISBURG INC
Entity type:Organization
Organization Name:COMMUNITY CHECK-UP CENTER OF SOUTH HARRISBURG INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:BELLISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-233-1700
Mailing Address - Street 1:38C HALL MNR
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-3044
Mailing Address - Country:US
Mailing Address - Phone:717-233-1700
Mailing Address - Fax:717-236-8752
Practice Address - Street 1:38C HALL MNR
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104-3044
Practice Address - Country:US
Practice Address - Phone:717-233-1700
Practice Address - Fax:717-236-8752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACOMCKUPCTROtherMEDICAID