Provider Demographics
NPI:1265578314
Name:LANCASTER GENERAL HOSPITAL
Entity type:Organization
Organization Name:LANCASTER GENERAL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:A
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-544-5658
Mailing Address - Street 1:554 N DUKE ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2225
Mailing Address - Country:US
Mailing Address - Phone:717-544-4943
Mailing Address - Fax:717-544-1961
Practice Address - Street 1:554 N DUKE ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2225
Practice Address - Country:US
Practice Address - Phone:717-544-4943
Practice Address - Fax:717-544-1961
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LANCASTER GENERAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-29
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X, 103TC0700X
PA1041C0700X, 207V00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1812923OtherHIGHMARK GROUP#
PA100771175 0005Medicaid
PA20045466OtherAMERIHEALTH MERCY
PA2648762000OtherAMERIHEALTH 65
PA50055923OtherCAPITAL BLUE CROSS
PA000000127890OtherUNISON - FPR GRP#
PAS1P1OtherGEISINGER
PA000000134934OtherUNISON - HBP GRP#
PA100771175 0005Medicaid
PA50055923OtherCAPITAL BLUE CROSS