MEDICARE: CATHOLIC CHARITIES OF THE DIOCESE OF HARRISBURG PA INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251K00000X	Public Health or Welfare Agency	327020	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134270945
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATHOLIC CHARITIES OF THE DIOCESE OF HARRISBURG PA INC

Provider Business Mailing Address
First Line	:	4800 UNION DEPOSIT ROAD
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17111-3551
Country	:	US
Telephone Number	:	717-657-4804
Fax Number	:	717-657-8683

Provider Business Practice Location Address
First Line	:	6156 WEST CANAL ROAD
Second Line	:
City	:	ABBOTTSTOWN
State	:	PA
Zip	:	17301-8982
Country	:	US
Telephone Number	:	717-657-4804
Fax Number	:	717-657-8683

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR CEO
Name	:	MARK A TOTARO
Credential	:	PHD
Telephone Number	:	717-657-4804

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	08/22/2020

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