Provider Demographics
NPI:1649517236
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:VP FINANCIAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:A
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-544-5010
Mailing Address - Street 1:99 MASONIC DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17022-2547
Mailing Address - Country:US
Mailing Address - Phone:717-689-4243
Mailing Address - Fax:717-689-1950
Practice Address - Street 1:99 MASONIC DR
Practice Address - Street 2:SUITE 101
Practice Address - City:ELIZABETHTOWN
Practice Address - State:PA
Practice Address - Zip Code:17022-2547
Practice Address - Country:US
Practice Address - Phone:717-689-4243
Practice Address - Fax:717-689-1950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty