Provider Demographics
NPI:1982608949
Name:HOSPICE OF CENTRAL PENNSYLVANIA
Entity Type:Organization
Organization Name:HOSPICE OF CENTRAL PENNSYLVANIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-732-1000
Mailing Address - Street 1:1320 LINGLESTOWN ROAD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-2822
Mailing Address - Country:US
Mailing Address - Phone:717-732-1000
Mailing Address - Fax:717-234-0416
Practice Address - Street 1:1320 LINGLESTOWN ROAD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-2822
Practice Address - Country:US
Practice Address - Phone:717-732-1000
Practice Address - Fax:717-234-0416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-08
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207RH0002X
PA153099251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No251G00000XAgenciesHospice Care, Community BasedGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007296450001Medicaid
39-1530Medicare ID - Type Unspecified