Healthcare Provider Details

I. General information

NPI: 1790757607
Provider Name (Legal Business Name): COUNTY OF YORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 03/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 PLEASANT ACRES RD
YORK PA
17402-8975
US

IV. Provider business mailing address

118 PLEASANT ACRES RD
YORK PA
17402-8975
US

V. Phone/Fax

Practice location:
  • Phone: 717-840-7103
  • Fax: 717-840-7414
Mailing address:
  • Phone: 717-840-7103
  • Fax: 717-840-7414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number250102
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. MARLIN L. PECK
Title or Position: ADMINISTRATOR
Credential: NHA
Phone: 717-840-7103