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101 Fairview Cir Lebanon PA 17042-9581 | |
(717) 279-7303 | |
(717) 279-7471 |
Full Name | |
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Speciality | Family Medicine |
Location | 101 Fairview Cir, 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 | 101 Fairview Cir Lebanon PA 17042-9581 Ph: (717) 279-7303 |
NPI Number | 1821429994 |
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Provider Enumeration Date | 11/27/2013 |
Last Update Date | 10/20/2016 |
Identifier | Type | State | Issuer |
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1821429994 | NPI | - | NPPES |
001864024 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (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 |