Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 960 Church St, Lebanon, Pennsylvania |
Authorized Official Name and Position | Alisa Maria Jones (PRESIDENT AND CEO) |
Authorized Official Contact | 7179451551 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
304 N Water St Lancaster PA 17603-3374 Ph: (717) 299-6372 | 960 Church St Lebanon PA 17046 Ph: (717) 299-6371 |
NPI Number | 1831836816 |
---|---|
Provider Enumeration Date | 05/19/2022 |
Last Update Date | 07/22/2024 |
Medicare PECOS PAC ID | 8123914322 |
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Medicare Enrollment ID | O20220606000894 |
Identifier | Type | State | Issuer |
---|---|---|---|
1831836816 | NPI | - | NPPES |
1007614190021 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (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 |