Healthcare Provider Details

I. General information

NPI: 1033147640
Provider Name (Legal Business Name): ELMWOOD ENDOSCOPY CENTER, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 6TH AVE SUITE 115
YORK PA
17403-2626
US

IV. Provider business mailing address

1600 6TH AVE SUITE 115
YORK PA
17403-2626
US

V. Phone/Fax

Practice location:
  • Phone: 717-718-7220
  • Fax: 717-718-7239
Mailing address:
  • Phone: 717-718-7220
  • Fax: 717-718-7239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number2049
License Number StatePA

VIII. Authorized Official

Name: CATHIE WEST LENTZ
Title or Position: PRACTICE MANAGER
Credential:
Phone: 717-755-7638