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General NPI Number Information
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NPI Number | 1093899775
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Entity Type | Organization
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Legal Business Name | MEMORIAL ENTERPRISES INC
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 05/19/2008
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Provider Practice Location Address
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Address Line | 4314 N GEORGE STREET EXT
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City | MANCHESTER
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State | PA
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Zip | 17345-1307
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Country | US
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Telephone | 717-266-0252
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Fax | 717-266-6908
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Provider Business Mailing Address
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Address Line | 1420 6TH AVE SUITE 4
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City | YORK
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State | PA
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Zip | 17403-2620
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Country | US
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Telephone | 717-815-2557
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Fax | 717-854-1434
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Authorized Official
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Title or Position | MGR OF FINANCE AND CODING
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Name | MS. LINDA A NEUBAUER
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Credential | CPC
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Telephone | 717-815-2557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS010093L
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License Number State | PA
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