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1000 Evelyn Dr Millersburg PA 17061-1258 | |
(717) 232-9971 | |
(717) 920-3039 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1000 Evelyn Dr, Millersburg, Pennsylvania |
Authorized Official Name and Position | Brooke Sheaffer (DIRECTOR OF BILLING AND UTILIZATION) |
Authorized Official Contact | 7172303926 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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110 S 17th St Harrisburg PA 17104-1123 Ph: (717) 232-9971 | 1000 Evelyn Dr Millersburg PA 17061-1258 Ph: (717) 232-9971 |
NPI Number | 1285192369 |
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Provider Enumeration Date | 03/07/2019 |
Last Update Date | 03/20/2019 |
Medicare PECOS PAC ID | 0042119547 |
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Medicare Enrollment ID | O20190722003263 |
Identifier | Type | State | Issuer |
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1285192369 | NPI | - | NPPES |
PENDING | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |