Healthcare Provider Details

I. General information

NPI: 1750330783
Provider Name (Legal Business Name): ENTERON, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 10/19/2021
Certification Date: 10/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

899 POPLAR CHURCH RD
CAMP HILL PA
17011-2206
US

IV. Provider business mailing address

899 POPLAR CHURCH RD
CAMP HILL PA
17011-2206
US

V. Phone/Fax

Practice location:
  • Phone: 717-763-0430
  • Fax: 717-763-9854
Mailing address:
  • Phone: 717-763-0430
  • Fax: 717-763-9854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: IRIS GARMAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 717-763-0430