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808 Pleasantview Dr Ephrata PA 17522-1644 | |
(717) 733-9090 | |
(717) 733-8982 |
Full Name | |
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Speciality | Family Medicine |
Location | 808 Pleasantview Dr, Ephrata, Pennsylvania |
Authorized Official Name and Position | Charles David Noll (VICE PRESIDENT) |
Authorized Official Contact | 7178515161 |
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 | 808 Pleasantview Dr Ephrata PA 17522-1644 Ph: (717) 733-9090 |
NPI Number | 1073547733 |
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Provider Enumeration Date | 07/10/2006 |
Last Update Date | 05/28/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1073547733 | NPI | - | NPPES |
1013977730013 | Medicaid | PA | |
DD6938 | Other | PA | RAILROAD MEDICARE |
1746358 | Other | PA | BLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |