MEDICARE: MONSTR HEALTHCARE MANAGEMENT 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	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1841477981
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONSTR HEALTHCARE MANAGEMENT LLC

Provider Business Mailing Address
First Line	:	1821 OREGON PIKE
Second Line	:	SUITE 2
City	:	LANCASTER
State	:	PA
Zip	:	17601-6466
Country	:	US
Telephone Number	:	717-581-0538
Fax Number	:	717-581-0539

Provider Business Practice Location Address
First Line	:	1821 OREGON PIKE
Second Line	:	SUITE 2
City	:	LANCASTER
State	:	PA
Zip	:	17601-6466
Country	:	US
Telephone Number	:	717-581-0538
Fax Number	:	717-581-0539

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MR. DENNIS T. PENNY JR.
Credential	:
Telephone Number	:	717-581-0538

Provider Enumeration Date	:	01/30/2008
Last Update Date	:	12/10/2008

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