Healthcare Provider Details
I. General information
NPI: 1255329645
Provider Name (Legal Business Name): LANCASTER LEASING PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/10/2005
Last Update Date: 09/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
125 S BROAD ST
LITITZ PA
17543-1808
US
IV. Provider business mailing address
125 S BROAD ST
LITITZ PA
17543-1808
US
V. Phone/Fax
- Phone: 717-626-0211
- Fax: 717-626-4441
- Phone: 717-626-0211
- Fax: 717-626-4441
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | 012302 |
| License Number State | PA |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 1007507380004 |
| Identifier Type | MEDICAID |
| Identifier State | PA |
| Identifier Issuer | |
VIII. Authorized Official
Name: MR.
FRANCIS
A
HAYMAN
JR.
Title or Position: PRESIDENT LEHIGH NURSING CORP.
Credential:
Phone: 610-264-8000