Healthcare Provider Details

I. General information

NPI: 1215268941
Provider Name (Legal Business Name): BARVINCHACK ASSOCIATES L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2010
Last Update Date: 01/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11142 WILLIAMSPORT PIKE
GREENCASTLE PA
17225-8516
US

IV. Provider business mailing address

PO BOX 460
GREENCASTLE PA
17225-0460
US

V. Phone/Fax

Practice location:
  • Phone: 717-597-9470
  • Fax: 717-597-1701
Mailing address:
  • Phone: 717-597-9470
  • Fax: 717-597-1701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberDC001177L
License Number StatePA

VIII. Authorized Official

Name: SAMUEL EVON BARVINCHACK
Title or Position: OWNER
Credential: D.C.
Phone: 717-597-9470