Healthcare Provider Details

I. General information

NPI: 1730568932
Provider Name (Legal Business Name): LANCASTER GENERAL MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2015
Last Update Date: 11/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

931 HARRISBURG AVE FRANKLIN & MARSHALL COLLEGE - APPEL HEALTH SERVICES
LANCASTER PA
17603-2652
US

IV. Provider business mailing address

931 HARRISBURG AVE FRANKLIN & MARSHALL COLLEGE - APPEL HEALTH SERVICES
LANCASTER PA
17603-2652
US

V. Phone/Fax

Practice location:
  • Phone: 717-544-9051
  • Fax: 717-735-9234
Mailing address:
  • Phone: 717-544-9051
  • Fax: 717-735-9234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DENISE A KENNEDY
Title or Position: VP FINANCIAL SERVICES
Credential:
Phone: 717-544-5010