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337 W Main St Suite 100 Leola PA 17540-2109 | |
(717) 656-6122 | |
(717) 656-0142 |
Full Name | |
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Speciality | Family Medicine |
Location | 337 W Main St, Leola, 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 | 337 W Main St Suite 100 Leola PA 17540-2109 Ph: (717) 656-6122 |
NPI Number | 1932155181 |
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Provider Enumeration Date | 05/26/2006 |
Last Update Date | 05/05/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1932155181 | NPI | - | NPPES |
1517089 | Other | PA | GATEWAY |
5372553 | Other | PA | AETNA |
1013977730018 | Medicaid | PA | |
1746348 | Other | PA | BLUE SHIELD |
50051234 | Other | PA | CAPITAL BLUE CROSS |
DD6938 | Other | PA | RR MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Leola Chiropractic Ltd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11 Holly Dr, Leola, PA 17540 Phone: 717-656-0032 Fax: 717-656-3019 | |