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General NPI Number Information
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NPI Number | 1396877726
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Entity Type | Organization
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Legal Business Name | REGIONAL GASTROENTEROLOGY ASSOCIATES OF LANCASTER, LTD
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 06/15/2012
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Provider Practice Location Address
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Address Line | 4140 OREGON PIKE
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City | EPHRATA
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State | PA
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Zip | 17522
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Country | US
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Telephone | 717-544-3400
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Fax | 717-544-3408
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Provider Business Mailing Address
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Address Line | 2104 HARRISBURG PIKE PO BOX 3200
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City | LANCASTER
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State | PA
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Zip | 17604-3200
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Country | US
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Telephone | 717-544-3400
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Fax | 717-544-3408
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Authorized Official
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Title or Position | PRESIDENT
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Name | DALE WHITEBLOOM
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Credential | DO
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Telephone | 717-544-3400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0800X
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Taxonomy Name | Endoscopy Clinic/Center
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License Number |
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License Number State | PA
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