Healthcare Provider Details

I. General information

NPI: 1568876092
Provider Name (Legal Business Name): PHYSICIANS' ALLIANCE LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2014
Last Update Date: 06/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 COLLEGE AVE SUITE 303
LANCASTER PA
17603-3372
US

IV. Provider business mailing address

1600 CLOISTER DR
LANCASTER PA
17601-2390
US

V. Phone/Fax

Practice location:
  • Phone: 717-735-3738
  • Fax: 717-735-3736
Mailing address:
  • Phone: 717-391-7092
  • Fax: 717-735-2069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberOS012014
License Number StatePA

VIII. Authorized Official

Name: MR. LEE MEYERS
Title or Position: EXECUTIVE VP AND COO
Credential:
Phone: 717-391-7092