MEDICARE: LANCASTER GENERAL HOSPITAL

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	207QG0300X	Geriatric Medicine (Family Medicine) Physician		PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	S1P6	OTHER	PA	GEISINGER
2	001399238	OTHER	PA	HIGHMARK BLUE SHIELD
3	000000136758	OTHER	PA	UNISON
4	20054139	OTHER	PA	AMERIHEALTH MERCY
5	2087959000	OTHER	PA	AMERIHEALTH 65

General Provider Information

NPI Number	:	1619023124
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LANCASTER GENERAL HOSPITAL

Provider Business Mailing Address
First Line	:	212 WILLOW VALLEY LAKES DR
Second Line	:
City	:	WILLOW STREET
State	:	PA
Zip	:	17584-9668
Country	:	US
Telephone Number	:	717-464-9173
Fax Number	:	717-464-0823

Provider Business Practice Location Address
First Line	:	212 WILLOW VALLEY LAKES DR
Second Line	:
City	:	WILLOW STREET
State	:	PA
Zip	:	17584-9668
Country	:	US
Telephone Number	:	717-464-9173
Fax Number	:	717-464-0823

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	GARY A WELCH
Credential	:
Telephone Number	:	717-544-5658

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	04/28/2025

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Directions to “LANCASTER GENERAL HOSPITAL ” Practice Location

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