Provider Demographics
NPI:1336875640
Name:PENN STATE HEALTH LANCASTER MEDICAL CENTER
Entity Type:Organization
Organization Name:PENN STATE HEALTH LANCASTER MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:CHABALOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-378-2288
Mailing Address - Street 1:500 UNIVERSITY DRIVE
Mailing Address - Street 2:MC CA410
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033
Mailing Address - Country:US
Mailing Address - Phone:717-531-1159
Mailing Address - Fax:717-531-0119
Practice Address - Street 1:2160 STATE RD STE 1316
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-1812
Practice Address - Country:US
Practice Address - Phone:223-287-8126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy