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General NPI Number Information
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NPI Number | 1629193016
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Entity Type | Organization
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Legal Business Name | COMMUNITY CHECK - UP CENTER
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 38C HALL MNR
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City | HARRISBURG
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State | PA
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Zip | 17104-3044
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Country | US
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Telephone | 717-233-1700
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Fax | 717-236-8752
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Provider Business Mailing Address
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Address Line | 38C HALL MNR
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City | HARRISBURG
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State | PA
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Zip | 17104-3044
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Country | US
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Telephone | 717-233-1700
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Fax | 717-236-8752
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Authorized Official
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Title or Position | PRESIDENT OF THE BOARD
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Name | MRS. GRETCHEN L BALLARD
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Credential | BSRN
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Telephone | 717-566-5812
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0005X
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Taxonomy Name | Ambulatory Family Planning Facility
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License Number | NA
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License Number State | PA
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