Provider Demographics
NPI:1720496961
Name:UNITED CEREBRAL PALSY OF CENTRAL PENNSYLVANIA, INC
Entity Type:Organization
Organization Name:UNITED CEREBRAL PALSY OF CENTRAL PENNSYLVANIA, INC
Other - Org Name:UCP CENTRAL PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BUNKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-737-3477
Mailing Address - Street 1:925 LINDA LN
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-6402
Mailing Address - Country:US
Mailing Address - Phone:717-737-3477
Mailing Address - Fax:717-975-3333
Practice Address - Street 1:925 LINDA LN
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-6402
Practice Address - Country:US
Practice Address - Phone:717-737-3477
Practice Address - Fax:717-975-3333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000015010025Medicaid