Provider Demographics
NPI: | 1932272341 |
---|---|
Name: | LANCASTER HMA PHYSICIAN MANAGEMENT, LLC |
Entity Type: | Organization |
Organization Name: | LANCASTER HMA PHYSICIAN MANAGEMENT, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | VICE PRESIDENT |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | MICHAEL |
Authorized Official - Middle Name: | L |
Authorized Official - Last Name: | GINGRAS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 239-598-3131 |
Mailing Address - Street 1: | 5811 PELICAN BAY BLVD |
Mailing Address - Street 2: | SUITE 500 |
Mailing Address - City: | NAPLES |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 34108-2704 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 239-598-3131 |
Mailing Address - Fax: | 239-598-9433 |
Practice Address - Street 1: | 1600 CLOISTER DR |
Practice Address - Street 2: | |
Practice Address - City: | LANCASTER |
Practice Address - State: | PA |
Practice Address - Zip Code: | 17601-2357 |
Practice Address - Country: | US |
Practice Address - Phone: | 717-391-7092 |
Practice Address - Fax: | 717-391-0793 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | HEALTH MANAGEMENT ASSOCIATES, INC |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2006-11-15 |
Last Update Date: | 2012-11-26 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
No | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Multi-Specialty |
No | 207RI0200X | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | Group - Multi-Specialty |
No | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | Group - Multi-Specialty |
No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |
No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
No | 208800000X | Allopathic & Osteopathic Physicians | Urology | Group - Multi-Specialty | |
No | 208G00000X | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Group - Multi-Specialty | |
No | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | Group - Multi-Specialty | |
No | 367500000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
PA | 1776576 | Medicaid | |
PA | 028667NDW | Medicare PIN |