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General NPI Number Information
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NPI Number | 1750696381
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Entity Type | Organization
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Legal Business Name | MEMORIAL ENTERPRISES, INC.
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Dates
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Enumeration Date | 08/06/2010
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Last Update Date | 06/10/2011
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Provider Practice Location Address
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Address Line | 3141 CAPE HORN RD
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City | RED LION
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State | PA
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Zip | 17356-9071
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Country | US
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Telephone | 717-815-2555
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Fax | 717-854-1434
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Provider Business Mailing Address
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Address Line | 3141 CAPE HORN RD
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City | RED LION
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State | PA
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Zip | 17356-9071
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Country | US
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Telephone | 717-815-2555
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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 | MS. LINDA A NEUBAUER
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Credential | CPC
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Telephone | 717-815-2557
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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 |
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License Number State |
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