Healthcare Provider Details

I. General information

NPI: 1760430342
Provider Name (Legal Business Name): THE MILTON S. HERSHEY MEDICAL CENTER PHYSICIANS GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 SCHOOLHOUSE RD
MIDDLETOWN PA
17057-3548
US

IV. Provider business mailing address

PO BOX 854 MC A410
HERSHEY PA
17033-0854
US

V. Phone/Fax

Practice location:
  • Phone: 717-948-5180
  • Fax:
Mailing address:
  • Phone: 717-531-5995
  • Fax: 717-531-6934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: DONALD MCKENNA
Title or Position: PRESIDENT
Credential:
Phone: 717-531-3979