Provider Demographics
NPI:1770546285
Name:GSH URGENT CARE, INC
Entity type:Organization
Organization Name:GSH URGENT CARE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR VICE PRESIDENT AND COO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-270-7762
Mailing Address - Street 1:956 ISABEL DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-7482
Mailing Address - Country:US
Mailing Address - Phone:717-270-5677
Mailing Address - Fax:717-274-1858
Practice Address - Street 1:956 ISABEL DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7482
Practice Address - Country:US
Practice Address - Phone:717-270-5677
Practice Address - Fax:717-274-1858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA158677OtherHEALTH AMERICA/ASSURANCE
PACI1341OtherPALMETTO GBA
PA50003047OtherCAPITAL BLUE CROSS
PA376476OtherHIGHMARK BLUE SHIELD
PA158677OtherHEALTH AMERICA/ASSURANCE