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General NPI Number Information
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NPI Number | 1689996407
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Entity Type | Organization
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Legal Business Name | MEMORIAL ENTERPRISES INC. D/B/A MEMORIAL PRIMARY CARE
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Dates
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Enumeration Date | 02/20/2010
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Last Update Date | 03/22/2010
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Provider Practice Location Address
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Address Line | 1232 GREENSPRINGS DR
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City | YORK
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State | PA
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Zip | 17402-8825
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Country | US
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Telephone | 717-755-6166
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Fax | 717-755-1591
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Provider Business Mailing Address
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Address Line | 1412 6TH AVE
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City | YORK
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State | PA
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Zip | 17403-2648
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Country | US
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Telephone | 717-845-8173
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Fax | 717-854-1434
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Authorized Official
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Title or Position | MANAGER OF FINANCE AND CODING
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Name | LINDA ANN NEUBAUER
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Credential |
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Telephone | 717-843-1420
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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 | OSO14851
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License Number State | PA
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