MEDICARE: MR. PHILIP EDWARD MCLAIN CRNA

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	367500000X	Certified Registered Nurse Anesthetist	RN287025L	PA
2	163W00000X	Registered Nurse	RN287025L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	001670922	OTHER	PA	HIGHMARK BLUE SHIELD
2	810715319	OTHER	PA	MULTI PLAN / PHCS

General Provider Information

NPI Number	:	1518950237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PHILIP EDWARD MCLAIN CRNA

Provider Business Mailing Address
First Line	:	118 WASHINGTON ST
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17104-1677
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4300 LONDONDERRY ROAD
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17109-5317
Country	:	US
Telephone Number	:	717-652-3000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2005
Last Update Date	:	11/09/2025

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