NPIMap

Organization Active NPI

Hanover Health Corporation, Inc.

Doing business as Carlos Medina, M.D.

  • Primary Care Clinic/Center
  • Hanover, PA
National Provider Identifier
1396887634
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
HANOVER HEALTH CORPORATION, INC.
Doing business as
Carlos Medina, M.D.
Practice address
100 Penn St
Hanover, PA 17331-1956
Phone
(717) 632-3220
Fax
(717) 632-3220
NPI assigned
Feb 13, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Marilyn A. Olejnik
Title
Chief Financial Officer
Phone
(717) 637-3711

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

100 Penn St
Hanover, PA 17331-1956

Mailing address

300 Highland Ave
Hanover, PA 17331-2297
Phone (717) 633-3511

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidPA

Other names 1

  • Carlos Medina, M.D. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hanover Surgicenter6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396887634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 HIGHLAND AVE",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173312297",
            "telephone_number": "717-633-3511",
            "fax_number": "717-646-0188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PENN ST",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173311956",
            "telephone_number": "717-632-3220",
            "fax_number": "717-632-3220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANOVER HEALTH CORPORATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OLEJNIK",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "717-637-3711",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carlos Medina, M.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hanover, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.