Healthcare Provider Details

I. General information

NPI: 1487923603
Provider Name (Legal Business Name): SENTINEL MANAGEMENT SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2011
Last Update Date: 12/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 W AIRPORT RD
LITITZ PA
17543-9259
US

IV. Provider business mailing address

118 W AIRPORT RD
LITITZ PA
17543-9259
US

V. Phone/Fax

Practice location:
  • Phone: 717-581-1245
  • Fax: 717-581-8841
Mailing address:
  • Phone: 717-581-1245
  • Fax: 717-581-8841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. ROBERT MELVIN HETTRICK II
Title or Position: PRESIDENT
Credential:
Phone: 717-581-1245