Healthcare Provider Details

I. General information

NPI: 1255049243
Provider Name (Legal Business Name): MILTON HERSHEY SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2022
Last Update Date: 11/09/2022
Certification Date: 11/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 HOMESTEAD LN
HERSHEY PA
17033-8818
US

IV. Provider business mailing address

1201 HOMESTEAD LN
HERSHEY PA
17033-8818
US

V. Phone/Fax

Practice location:
  • Phone: 717-520-3000
  • Fax: 717-520-2148
Mailing address:
  • Phone: 717-520-3000
  • Fax: 717-520-2148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code364SS0200X
TaxonomySchool Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: MR. VICTOR R FLEMING
Title or Position: DIRECTOR OF HEALTH SERVICES SYSTEMS
Credential:
Phone: 717-520-2182