MEDICARE: SPRING GROVE FAMILY CARE CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1376644724
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPRING GROVE FAMILY CARE CENTER LLC

Provider Business Mailing Address
First Line	:	2030 THISTLE HILL DR
Second Line	:	SUITE 200
City	:	SPRING GROVE
State	:	PA
Zip	:	17362-1159
Country	:	US
Telephone Number	:	717-225-6556
Fax Number	:	717-225-0356

Provider Business Practice Location Address
First Line	:	2030 THISTLE HILL DR
Second Line	:	SUITE 200
City	:	SPRING GROVE
State	:	PA
Zip	:	17362-1159
Country	:	US
Telephone Number	:	717-225-6556
Fax Number	:	717-225-0356

Authorized Official
Title or Position	:	OWNER
Name	:	DR. HOWARD H. FARRINGTON III
Credential	:	M.D.
Telephone Number	:	717-225-6556

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	05/29/2014

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