MEDICARE: CITY OF YORK BUREAU OF HEALTH

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	2083P0901X	Public Health & General Preventive Medicine Physician	PN263093	PA
2	364SC1501X	Community Health/Public Health Clinical Nurse Specialist	RN523115L	PA
3	364SC1501X	Community Health/Public Health Clinical Nurse Specialist	RN213552L	PA
4	261QP0905X	State or Local Public Health Clinic/Center	MD070102L	PA

General Provider Information

NPI Number	:	1821500620
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF YORK BUREAU OF HEALTH

Provider Business Mailing Address
First Line	:	435 W PHILADELPHIA ST
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17401-3340
Country	:	US
Telephone Number	:	717-849-2299
Fax Number	:	717-843-5605

Provider Business Practice Location Address
First Line	:	435 W PHILADELPHIA ST
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17401-3340
Country	:	US
Telephone Number	:	717-849-2299
Fax Number	:	717-843-5605

Authorized Official
Title or Position	:	PERSONAL HEALTH SERVICES SUPERVISOR
Name	:	MONICA KRUGER
Credential	:	MPH
Telephone Number	:	717-849-2293

Provider Enumeration Date	:	11/02/2017
Last Update Date	:	11/02/2017

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