NPIMap

Organization Active NPI

LCH Health and Community Services

  • Federally Qualified Health Center (FQHC)
  • West Grove, PA
National Provider Identifier
1063901205
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LCH HEALTH AND COMMUNITY SERVICES
Practice address
105 Vineyard Way Ste 200
West Grove, PA 19390-8849
Phone
(610) 444-7550
Fax
(610) 444-4656
NPI assigned
May 3, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2023

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

Authorized official

Name
Ronan Gannon
Title
Ceo
Phone
(610) 444-7550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

105 Vineyard Way Ste 200
West Grove, PA 19390-8849

Mailing address

731 W Cypress St
Kennett Square, PA 19348-2419
Phone (610) 444-7550

Other identifiers 1

IdentifierTypeStateIssuer
100752680-0011MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050310000620 PA Part B Supplier - Clinic/Group Practice 2466406574 Receives reassigned benefits from 27 practitioners
5 other NPIs on this enrollment
Practice locations: Kennett Square, PA; Oxford, PA; West Grove, PA
O20190620000187 PA Part A Provider - Federally Qualified Health Center (FQHC) 2466406574 Practice locations: West Grove, PA

Federally qualified health center certification: CCN 391136

Legal name
LCH HEALTH AND COMMUNITY SERVICES
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 18, 2019
Last certification
Jun 18, 2019
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 14, 1974 in PA
Enrollment address
105 Vineyard Way
Ste 200
West Grove, PA 19390-8849

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

105 Vineyard Way
Ste 200
West Grove, PA 19390
Phone (610) 345-0020

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Alice K Moorehead Individual Corporate Director Jan 1, 2005
Barbara E Harrison McPherson Individual Corporate Director Jan 19, 2021
Leah Whyte Individual Corporate Director Jan 1, 2021
Sara Dickens-Trillo Individual Corporate Director Jan 18, 2021
Jeanne Franklin Individual Corporate DirectorVice Chairperson Jan 16, 2021
Andrea Hickey Mills Individual Corporate Director Jan 1, 2018
Domenic Vacca Individual Corporate Director Jan 1, 2016
Jorge Duchini Individual Corporate Director Jan 19, 2021
John Rafferty Individual Corporate DirectorSecretary Jan 1, 2018
Pia McCann Individual Corporate DirectorChairperson Jan 1, 2016
Nolan Bennett Individual Corporate Director Jan 18, 2021
Ronan Gannon Individual Corporate OfficerCeo Apr 1, 2021
W-2 Managing EmployeeCeo Apr 1, 2021
Christopher G Close Individual Corporate Director Jan 1, 2021
Brian Kornet Individual Corporate DirectorTreasurer Jan 1, 2019

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
LCH Health and Community ServicesOxford, PA, CCN 731876 Federally qualified health center 5% Or Greater Direct Ownership Interest
Other		 May 1, 1980
May 1, 1980

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1525305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684800000000",
    "number": "1063901205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 W CYPRESS ST",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193482419",
            "telephone_number": "610-444-7550",
            "fax_number": "610-444-4656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 VINEYARD WAY STE 200",
            "city": "WEST GROVE",
            "state": "PA",
            "postal_code": "193908849",
            "telephone_number": "610-444-7550",
            "fax_number": "610-444-4656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LCH HEALTH AND COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-03",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A",
        "authorized_official_last_name": "GANNON",
        "authorized_official_first_name": "RONAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "610-444-7550"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100752680-0011",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Grove, PA

Sources for this page

Verify at the official NPI Registry.