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General NPI Number Information
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NPI Number | 1235441742
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Entity Type | Organization
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Legal Business Name | WATER STREET HEALTH SERVICES
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Dates
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Enumeration Date | 07/13/2010
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Last Update Date | 07/13/2010
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Provider Practice Location Address
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Address Line | 210 S PRINCE ST
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City | LANCASTER
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State | PA
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Zip | 17603-5314
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Country | US
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Telephone | 717-358-2017
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Fax | 717-393-1017
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Provider Business Mailing Address
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Address Line | 210 S PRINCE ST
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City | LANCASTER
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State | PA
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Zip | 17603-5314
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Country | US
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Telephone | 717-358-2017
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Fax | 717-393-1017
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | GALE THOMASON
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Credential | RN, BSN
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Telephone | 717-358-2092
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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