Provider Demographics
NPI:1134770720
Name:CENTRAL PENNSYLVANIA ALLIANCE LABORATORY LLC
Entity type:Organization
Organization Name:CENTRAL PENNSYLVANIA ALLIANCE LABORATORY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:C
Authorized Official - Last Name:COTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-738-6114
Mailing Address - Street 1:1803 MOUNT ROSE AVE STE C-3C4
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3026
Mailing Address - Country:US
Mailing Address - Phone:888-480-1422
Mailing Address - Fax:717-738-6533
Practice Address - Street 1:1803 MOUNT ROSE AVE STE C-3C4
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3026
Practice Address - Country:US
Practice Address - Phone:888-480-1422
Practice Address - Fax:717-738-6533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-25
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory