Healthcare Provider Details

I. General information

NPI: 1932490398
Provider Name (Legal Business Name): LANCASTER GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2011
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 N LIME ST
LANCASTER PA
17602-2748
US

IV. Provider business mailing address

223 N LIME ST
LANCASTER PA
17602-2748
US

V. Phone/Fax

Practice location:
  • Phone: 717-394-3793
  • Fax: 717-396-7409
Mailing address:
  • Phone: 717-394-3793
  • Fax: 717-396-7409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number120801
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number120801
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number120801
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number120801
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number120801
License Number StatePA
# 6
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number120801
License Number StatePA
# 7
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number120801
License Number StatePA
# 8
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number120801
License Number StatePA
# 9
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number120801
License Number StatePA

VIII. Authorized Official

Name: STACY GRECO
Title or Position: PAYER ENROLLMENT MANAGER
Credential:
Phone: 223-341-8516