| Pine Grove Adult Medicine | |
|
300 Pine Grove Commons York PA 17403-5176 | |
| (717) 812-2143 | |
| (717) 812-2163 |
| Full Name | Pine Grove Adult Medicine |
|---|---|
| Speciality | Internal Medicine |
| Location | 300 Pine Grove Commons, York, Pennsylvania |
| Authorized Official Name and Position | Amy F Wilkinson (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 7178511405 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine Grove Adult Medicine 1803 Mount Rose Ave Suite B3 York PA 17403-3051 Ph: (717) 851-1405 | Pine Grove Adult Medicine 300 Pine Grove Commons York PA 17403-5176 Ph: (717) 812-2143 |
| NPI Number | 1265591481 |
|---|---|
| Provider Enumeration Date | 12/06/2006 |
| Last Update Date | 08/11/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265591481 | NPI | - | NPPES |
| 800174 | Other | PA | JOHN HOPKINS |
| 1007721360258 | Medicaid | PA | |
| KX54 | Other | MD | CAREFIRST MD BCBS |
| 50023472 | Other | PA | CAPITAL BLUE CROSS |
| 1471291 | Other | PA | HIGHMARK BLUE SHIELD |
| 1531858 | Other | PA | GATEWAY |
| 20022918 | Other | PA | AMERIHEALTH MERCY |
| 2155344001 | Other | PA | AMERIHEALTH 65 PA |
| 7689843 | Other | PA | AETNA |
| S1EY | Other | PA | GEISINGER |
| CA3246 | Other | PA | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
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