Provider Demographics
NPI:1982228185
Name:THE MILTON S. HERSHEY MEDICAL CENTER PHYSICIAN GROUP
Entity Type:Organization
Organization Name:THE MILTON S. HERSHEY MEDICAL CENTER PHYSICIAN GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER ENROLLMENT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:HITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-531-5995
Mailing Address - Street 1:PO BOX 858
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-0858
Mailing Address - Country:US
Mailing Address - Phone:717-531-5814
Mailing Address - Fax:717-531-0494
Practice Address - Street 1:500 UNIVERSITY DR STE 400
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2360
Practice Address - Country:US
Practice Address - Phone:717-531-6822
Practice Address - Fax:717-531-4907
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MILTON S HERSHEY MEDICAL CENTER PHYSICIANS GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty