NPIMap

Organization Active NPI

Evangelical Medical Services Organization

Doing business as EMSO MGMG Lab

  • Clinical Medical Laboratory
  • Mifflinburg, PA
National Provider Identifier
1053591859
Registry record updated Nov 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
EVANGELICAL MEDICAL SERVICES ORGANIZATION
Doing business as
EMSO MGMG Lab
Practice address
101 Meadow Green Dr
Mifflinburg, PA 17844-9300
Phone
(570) 966-1122
Fax
(570) 966-1182
NPI assigned
Nov 8, 2007
Last updated
Nov 8, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Kendra A. Aucker
Title
Vice President
Phone
(570) 522-2807

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X PA Primary

Addresses

Primary practice location

101 Meadow Green Dr
Mifflinburg, PA 17844-9300

Mailing address

130 Hospital Dr
Lewisburg, PA 17837-9315
Phone (570) 522-4134

Other identifiers 1

IdentifierTypeStateIssuer
1007498260006MedicaidPA

Other names 1

  • EMSO MGMG Lab Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Emergency Group Emsf13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

130 Hospital Dr
#5965
Lewisburg, PA 17837

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194480000000",
    "number": "1053591859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 HOSPITAL DR",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178379315",
            "telephone_number": "570-522-4134",
            "fax_number": "570-522-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MEADOW GREEN DR",
            "city": "MIFFLINBURG",
            "state": "PA",
            "postal_code": "178449300",
            "telephone_number": "570-966-1122",
            "fax_number": "570-966-1182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANGELICAL MEDICAL SERVICES ORGANIZATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-08",
        "last_updated": "2007-11-08",
        "status": "A",
        "authorized_official_last_name": "AUCKER",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "570-522-2807",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007498260006",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EMSO MGMG Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mifflinburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.