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562 West 2nd Avenue Lititz PA 17543-1816 | |
(717) 626-2167 | |
(717) 626-1915 |
Full Name | |
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Speciality | Family Medicine |
Location | 562 West 2nd Avenue, Lititz, Pennsylvania |
Authorized Official Name and Position | Denise Kennedy (VICE PRESIDENT FINANCIAL SERVICES) |
Authorized Official Contact | 7175445010 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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562 West 2nd Avenue Lititz PA 17543-1816 Ph: (717) 626-2167 | 562 West 2nd Avenue Lititz PA 17543-1816 Ph: (717) 626-2167 |
NPI Number | 1164405593 |
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Provider Enumeration Date | 11/21/2005 |
Last Update Date | 11/16/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164405593 | NPI | - | NPPES |
1007327490074 | Medicaid | PA | |
128360 | Other | PA | HIGHMARK BLUE SHIELD |
5913568 | Other | PA | AETNA NON-HMO |
CC3129 | Other | PA | RAILROAD MEDICARE |
1294 | Other | PA | AETNA HMO |
85047 | Other | PA | AETNA CAP OFFICE# |
03093600 | Other | PA | CAPITAL BLUE CROSS |
S1QG | Other | PA | GEISINGER HEALTH PLAN |
1518494 | Other | PA | GATEWAY HEALTH PLAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Pennsylvania Institute Of Endocrinology Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1575 Highlands Dr, Suite 206, Lititz, PA 17543 Phone: 717-568-8886 Fax: 717-627-2727 | |