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4131 Oregon Pike Ephrata PA 17522-9550 | |
(717) 859-1123 | |
(717) 859-2898 |
Full Name | |
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Speciality | Family Medicine |
Location | 4131 Oregon Pike, Ephrata, Pennsylvania |
Authorized Official Name and Position | Charles David Noll (VICE PRESIDENT) |
Authorized Official Contact | 7178595161 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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4131 Oregon Pike Suite C Ephrata PA 17522-9550 Ph: (717) 859-5161 | 4131 Oregon Pike Ephrata PA 17522-9550 Ph: (717) 859-1123 |
NPI Number | 1023048592 |
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Provider Enumeration Date | 07/03/2006 |
Last Update Date | 05/05/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023048592 | NPI | - | NPPES |
50051184 | Other | PA | CAPITAL BLUE CROSS GROUP |
000000168397 | Other | PA | UNISON HEALTH PLAN |
DD6938 | Other | PA | RAILROAD MEDICARE |
1517082 | Other | PA | GATEWAY GROUP NUMBER |
2412013000 | Other | PA | BLUE SHIELD PA |
4620221 | Other | PA | AETNA GROUP NUMBER |
1013977730004 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |