MEDICARE: LEMOYNE PRIMARY CARE PC

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	261QP2300X	Primary Care Clinic/Center	OS004743L	PA

General Provider Information

NPI Number	:	1861871352
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEMOYNE PRIMARY CARE PC

Provider Business Mailing Address
First Line	:	797 POPLAR CHURCH RD
Second Line	:
City	:	CAMP HILL
State	:	PA
Zip	:	17011-2314
Country	:	US
Telephone Number	:	717-695-9177
Fax Number	:

Provider Business Practice Location Address
First Line	:	797 POPLAR CHURCH RD
Second Line	:
City	:	CAMP HILL
State	:	PA
Zip	:	17011-2314
Country	:	US
Telephone Number	:	717-695-9177
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JANE K CONROY
Credential	:	DO
Telephone Number	:	717-903-3228

Provider Enumeration Date	:	05/29/2015
Last Update Date	:	06/15/2016

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