Norther Lancaster County Medical Group

Organization Active NPI Non-Pharmacy Dispensing Site · Brownstown, PA

NPI 1508047606 · NPPES record last updated Mar 31, 2015

Key facts

NPI
1508047606
Entity type
Organization (NPI type 2)
Primary specialty
Non-Pharmacy Dispensing Site 332900000X
License
OS004463L (PA)
Legal business name
NORTHER LANCASTER COUNTY MEDICAL GROUP
Practice address
4131 Oregon Pike
Brownstown, PA 17508-5083
Phone
(717) 859-1123
NPI assigned
Nov 16, 2007
Organization subpart
Yes
Parent organization (as reported)
MEDVANTX, INC.

Authorized official

Name
Kenny Heine
Title
VP of Operations
Phone
(858) 625-2990

Corporate family (same tax ID) 1

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

National Provider Directory

Tax ID family
Ephrata Community Hospital (2 organizations share this tax ID)
Part of
Tri - State Medical Group Inc

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X OS004463L PA Yes

Addresses

Primary practice location

4131 Oregon Pike
Brownstown, PA 17508-5083

Mailing address

5626 Oberlin Dr
Suite 110
San Diego, CA 92121-1705

Other names

  • Wellspan Family Medicine - Crossroads Doing business as

Other providers in Brownstown, PA

All providers in Brownstown, PA · Non-Pharmacy Dispensing Site in Pennsylvania

Sources for this page

Verify at the official NPI Registry.