| Gaudenzia Elsie Shenk Outpatient | |
|
211 East Mifflin Street Lancaster PA 17602 | |
| (717) 286-9088 | |
| (717) 286-9091 |
| Full Name | Gaudenzia Elsie Shenk Outpatient |
|---|---|
| Speciality | Clinic/center |
| Location | 211 East Mifflin Street, Lancaster, Pennsylvania |
| Authorized Official Name and Position | Michael J Moyle (DIR. FISCAL & CORPORATE OPERATIONS) |
| Authorized Official Contact | 6102399600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gaudenzia Elsie Shenk Outpatient 106 West Main Street Norristown PA 19401-4716 Ph: (610) 239-9600 | Gaudenzia Elsie Shenk Outpatient 211 East Mifflin Street Lancaster PA 17602 Ph: (717) 286-9088 |
| NPI Number | 1447478193 |
|---|---|
| Provider Enumeration Date | 04/20/2007 |
| Last Update Date | 01/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447478193 | NPI | - | NPPES |
| 1002285890060 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 367081 (Pennsylvania) | Secondary |
| 261Q00000X | Clinic/center | 367081 (Pennsylvania) | Primary |
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