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761 Norman Drive Lebanon PA 17042-7497 | |
(717) 376-1180 | |
(717) 376-1184 |
Full Name | |
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Speciality | Internal Medicine - Gastroenterology |
Location | 761 Norman Drive, Lebanon, Pennsylvania |
Authorized Official Name and Position | Jody M Boger (CREDENTIALING COORDINATOR) |
Authorized Official Contact | 7172707780 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 300 Lebanon PA 17042-0300 Ph: (717) 270-7780 | 761 Norman Drive Lebanon PA 17042-7497 Ph: (717) 376-1180 |
NPI Number | 1497021018 |
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Provider Enumeration Date | 03/28/2012 |
Last Update Date | 10/05/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1497021018 | NPI | - | NPPES |
001864024 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
Agape Family Medicine, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 Cumberland St, Lebanon, PA 17042 Phone: 717-270-0335 Fax: 717-270-9740 | |
Lebanon Family Health Service Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 615 Cumberland St, Lebanon, PA 17042 Phone: 717-273-6741 Fax: 717-273-6337 |