Healthcare Provider Details

I. General information

NPI: 1730334244
Provider Name (Legal Business Name): SPIRIT PHYSICIAN SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2008
Last Update Date: 11/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 N 21ST ST SUITE 202
CAMP HILL PA
17011-2207
US

IV. Provider business mailing address

205 GRANDVIEW AVE SUITE 210
CAMP HILL PA
17011
US

V. Phone/Fax

Practice location:
  • Phone: 717-763-9880
  • Fax: 717-737-2765
Mailing address:
  • Phone: 717-972-4480
  • Fax: 717-972-4656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name: GERALD B OSMAN
Title or Position: VICE-PRESIDENT, COO
Credential:
Phone: 717-972-4480