Crystal Derose, | |
306 N 7th St, Columbia, PA 17512-2137 | |
(717) 560-3782 | |
(717) 560-3787 |
Full Name | Crystal Derose |
---|---|
Gender | Female |
Speciality | Counselor - Professional |
Location | 306 N 7th St, Columbia, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1083155410 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | PC008595 (Pennsylvania) | Primary |
Entity Name | Lancaster General Medical Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1952392383 PECOS PAC ID: 0941103683 Enrollment ID: O20040309000916 |
Mailing Address | Practice Location Address |
---|---|
Crystal Derose, 306 N 7th St, Columbia, PA 17512-2137 Ph: (717) 560-3782 | Crystal Derose, 306 N 7th St, Columbia, PA 17512-2137 Ph: (717) 560-3782 |
Jediah Bulgrien, Counselor Medicare: Not Enrolled in Medicare Practice Location: 610 Poplar St, Columbia, PA 17512 Phone: 717-449-5888 Fax: 717-449-5891 | |
Melany Ayala, Counselor Medicare: Not Enrolled in Medicare Practice Location: 610 Poplar St, Columbia, PA 17512 Phone: 717-449-5888 | |
Hannah Stoner, Counselor Medicare: Not Enrolled in Medicare Practice Location: 610 Poplar St, Columbia, PA 17512 Phone: 717-449-5888 | |
Sydney Hoover, Counselor Medicare: Not Enrolled in Medicare Practice Location: 610 Poplar St, Columbia, PA 17512 Phone: 717-449-5888 Fax: 717-449-5891 | |
Cassie Coder, CADC, MBAHM Counselor Medicare: Not Enrolled in Medicare Practice Location: 1290 Prospect Rd, Columbia, PA 17512 Phone: 717-285-0420 Fax: 717-285-0435 | |
Jake Mouliert, Counselor Medicare: Not Enrolled in Medicare Practice Location: 610 Poplar St, Columbia, PA 17512 Phone: 717-449-5888 |