Provider Demographics
NPI:1336531490
Name:CARLISLE HMA LLC
Entity Type:Organization
Organization Name:CARLISLE HMA LLC
Other - Org Name:CARLISLEREGIONAL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLTSFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-465-7466
Mailing Address - Street 1:361 ALEXANDER SPRING RD
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17015-6940
Mailing Address - Country:US
Mailing Address - Phone:717-960-3520
Mailing Address - Fax:
Practice Address - Street 1:361 ALEXANDER SPRING RD
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17015-6940
Practice Address - Country:US
Practice Address - Phone:717-960-3520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARLISLE HMA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-02-26
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA035801273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPENDINGMedicare Oscar/Certification