=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427034230
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MEMORIAL HOSPITAL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/22/2005
-----------------------------------------------------
Last Update Date | 05/10/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1412 6TH AVE
-----------------------------------------------------
City | YORK
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17403-2648
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-849-5635
-----------------------------------------------------
Fax | 717-849-5630
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1412 SIXTH AVENUE
-----------------------------------------------------
City | YORK
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17403-2648
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-849-5635
-----------------------------------------------------
Fax | 717-849-5630
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | BARBARA ANN NESBIT
-----------------------------------------------------
Credential | RN,BSN,MHA
-----------------------------------------------------
Telephone | 717-849-5635
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 747405
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------