MEDICARE: LANCASTER PET PARTNERSHIP, LLP

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	261QR0200X	Radiology Clinic/Center

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	:	1588668180
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LANCASTER PET PARTNERSHIP, LLP

Provider Business Mailing Address
First Line	:	PO BOX 4216
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17604-4216
Country	:	US
Telephone Number	:	717-394-6028
Fax Number	:	717-509-6362

Provider Business Practice Location Address
First Line	:	2100 HARRISBURG PIKE
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17601-2644
Country	:	US
Telephone Number	:	717-544-3030
Fax Number	:	717-544-3220

Authorized Official
Title or Position	:	CREDENTIALING SPECIALIST
Name	:	DORI MOWERY
Credential	:
Telephone Number	:	717-412-1289

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	05/20/2025

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