| |
111 S Front St Harrisburg PA 17101-2010 | |
(717) 782-3131 | |
Not Available |
Full Name | |
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Speciality | Clinic/center |
Location | 111 S Front St, Harrisburg, Pennsylvania |
Authorized Official Name and Position | Roger Longenderfer (PRESIDENT AND CEO) |
Authorized Official Contact | 7172308200 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 8700 Harrisburg PA 17105-8700 Ph: () - | 111 S Front St Harrisburg PA 17101-2010 Ph: (717) 782-3131 |
NPI Number | 1346344090 |
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Provider Enumeration Date | 09/12/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1346344090 | NPI | - | NPPES |
1374130 | Other | PA | HIGHMARK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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