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General NPI Number Information
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NPI Number | 1720061831
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Entity Type | Organization
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Legal Business Name | LANCASTER GASTROENTEROLOGY PROCEDURE CENTER LLC
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Dates
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Enumeration Date | 11/22/2005
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Last Update Date | 11/14/2008
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Provider Practice Location Address
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Address Line | 2112 HARRISBURG PIKE SUITE 323
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City | LANCASTER
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State | PA
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Zip | 17601-2644
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Country | US
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Telephone | 717-544-3569
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Fax | 717-544-3570
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Provider Business Mailing Address
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Address Line | 2112 HARRISBURG PIKE SUITE 323
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City | LANCASTER
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State | PA
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Zip | 17601-2644
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Country | US
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Telephone | 717-544-3569
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Fax | 717-544-3570
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Authorized Official
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Title or Position | CHIEF MANAGER OF LLC
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Name | MR. CHRISTOPHER A HOLDEN
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Credential |
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Telephone | 615-665-1283
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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 | 17211501
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License Number State | PA
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