Provider Demographics
NPI: | 1245714773 |
---|---|
Name: | LANCASTER GENERAL MEDICAL GROUP |
Entity type: | Organization |
Organization Name: | LANCASTER GENERAL MEDICAL GROUP |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | VICE PRESIDENT FINANCIAL SERVICES |
Authorized Official - Prefix: | |
Authorized Official - First Name: | DENISE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | KENNEDY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 717-544-5010 |
Mailing Address - Street 1: | 51 PETERS RD |
Mailing Address - Street 2: | |
Mailing Address - City: | LITITZ |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 17543-7685 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 717-627-8225 |
Mailing Address - Fax: | 717-627-8226 |
Practice Address - Street 1: | 51 PETERS RD |
Practice Address - Street 2: | |
Practice Address - City: | LITITZ |
Practice Address - State: | PA |
Practice Address - Zip Code: | 17543-7685 |
Practice Address - Country: | US |
Practice Address - Phone: | 717-627-8225 |
Practice Address - Fax: | 717-627-8226 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2018-09-20 |
Last Update Date: | 2020-11-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Multi-Specialty |
No | 208VP0014X | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine | Group - Multi-Specialty |
No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Multi-Specialty |
No | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty | |
No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
No | 207VF0040X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Urogynecology and Reconstructive Pelvic Surgery | Group - Multi-Specialty |
No | 207VG0400X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology | Group - Multi-Specialty |
No | 207VX0000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Obstetrics | Group - Multi-Specialty |
No | 207VX0201X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecologic Oncology | Group - Multi-Specialty |
No | 208800000X | Allopathic & Osteopathic Physicians | Urology | Group - Multi-Specialty | |
No | 2088F0040X | Allopathic & Osteopathic Physicians | Urology | Urogynecology and Reconstructive Pelvic Surgery | Group - Multi-Specialty |
No | 208VP0000X | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine | Group - Multi-Specialty |