| |
283 S Butler Rd Lebanon PA 17042-8939 | |
(717) 270-2422 | |
(717) 279-2792 |
Full Name | |
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Speciality | Clinic/center |
Location | 283 S Butler Rd, Lebanon, Pennsylvania |
Authorized Official Name and Position | Mantha Kotsalos (VP & PRESIDENT PHILHAVEN) |
Authorized Official Contact | 7172702423 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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601 Memory Ln York PA 17402-2231 Ph: (717) 851-1405 | 283 S Butler Rd Lebanon PA 17042-8939 Ph: (717) 270-2422 |
NPI Number | 1275758393 |
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Provider Enumeration Date | 04/16/2007 |
Last Update Date | 10/18/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275758393 | NPI | - | NPPES |
1007720000131 | Medicaid | PA | |
1007720000134 | Medicaid | PA | |
1007720000135 | Medicaid | PA | |
1007720000128 | Medicaid | PA | |
1007720000127 | Medicaid | PA | |
1007720000132 | Medicaid | PA | |
1007720000076 | Medicaid | PA | |
1007720000133 | Medicaid | PA | |
1007720000136 | Medicaid | PA | |
1007720000137 | Medicaid | PA | |
1007720000138 | Medicaid | PA | |
1007720000152 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Secondary |
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 |