Healthcare Provider Details
I. General information
NPI: 1699798942
Provider Name (Legal Business Name): YORK HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/26/2006
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
43 SOUTH COLUMBUS AVE SUITE 100 WELLSPAN DIALYSIS - LITTLESTOWN
LITTLESTOWN PA
17340
US
IV. Provider business mailing address
601 MEMORY LN
YORK PA
17402-2231
US
V. Phone/Fax
- Phone: 717-359-8110
- Fax: 717-359-8920
- Phone: 717-851-1405
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QE0700X |
| Taxonomy | End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| License Number | 250301 |
| License Number State | PA |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 0001939000 |
| Identifier Type | MEDICAID |
| Identifier State | PA |
| Identifier Issuer | |
| # 2 | |
| Identifier | 60592 |
| Identifier Type | MEDICAID |
| Identifier State | PA |
| Identifier Issuer | |
| # 3 | |
| Identifier | 7926 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | GEISINGER |
| # 4 | |
| Identifier | 229284 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | MAMSI, ALLIANCE, OPTIMUM |
| # 5 | |
| Identifier | 390046 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | CAPITAL BLUE CROSS & KHP |
| # 6 | |
| Identifier | 000000056673 |
| Identifier Type | MEDICAID |
| Identifier State | PA |
| Identifier Issuer | |
| # 7 | |
| Identifier | 393505 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | MEDICARE |
| # 8 | |
| Identifier | 390770 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | BLUE CROSS |
| # 9 | |
| Identifier | 100196547 |
| Identifier Type | MEDICAID |
| Identifier State | PA |
| Identifier Issuer | |
| # 10 | |
| Identifier | 218968 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | HEALTHAMERICA |
| # 11 | |
| Identifier | 08263 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | HEALTH PARTNERS |
| # 12 | |
| Identifier | 0942174000 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | KEYSTONE |
| # 13 | |
| Identifier | 1027680 |
| Identifier Type | MEDICAID |
| Identifier State | PA |
| Identifier Issuer | |
| # 14 | |
| Identifier | 676462 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | AETNA |
VIII. Authorized Official
Name:
MICHAEL
F
O'CONNOR
Title or Position: SR VP - FINANCE
Credential:
Phone: 717-851-2123
