Healthcare Provider Details

I. General information

NPI: 1518342732
Provider Name (Legal Business Name): LANCASTER HMA PHYSICIAN MANAGEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2015
Last Update Date: 07/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 COLLEGE AVE
LANCASTER PA
17603-3363
US

IV. Provider business mailing address

250 COLLEGE AVE
LANCASTER PA
17603-3363
US

V. Phone/Fax

Practice location:
  • Phone: 717-358-7349
  • Fax:
Mailing address:
  • Phone: 717-358-7349
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DENNIS HERTZ
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 717-291-8078