Evangelical Medical Services Organization
Organization Active NPI Anatomic Pathology Physician · Lewisburg, PA
NPI 1508966722 · NPPES record last updated Sep 9, 2024
Key facts
- NPI
- 1508966722
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Anatomic Pathology Physician 207ZP0101X
- Legal business name
- EVANGELICAL MEDICAL SERVICES ORGANIZATION
- Practice address
- 1 Hospital Dr
Lewisburg, PA 17837-9350 - Phone
- (570) 522-4110
- Fax
- (570) 768-3911
- NPI assigned
- Sep 25, 2006
- Organization subpart
- No
Authorized official
- Name
- Kendra A Aucker
- Title
- Senior Vice President/President
- Phone
- (570) 522-2807
Other NPIs on the same Medicare enrollment 7
Corporate family (same tax ID) 12
Practitioners 3
-
Maria Mabel Fasano, M.D.
-
Liu Liu, M.D., PH.D.
-
Stephen Wall, D.O.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040310000212 | PA | Part B Supplier - Clinic/Group Practice | 9133033087 |
Receives reassigned benefits from 372 practitioners 7 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Lewisburg, PA; Middleburg, PA; Mifflinburg, PA; Milton, PA; New Columbia, PA; Northumberland, PA; Selinsgrove, PA; Shamokin Dam, PA… |
National Provider Directory
- Tax ID family
- Lewisburg Family Practi
Locations
210 Jpm Rd
Ste 100
Lewisburg, PA 17837
Phone (570) 524-6700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cytopathology Physician |
207ZC0500X | PA | ||
| Anatomic Pathology Physician |
207ZP0101X | PA | Yes |
Addresses
Primary practice location
1 Hospital Dr
Lewisburg, PA 17837-9350
Mailing address
1 Hospital Dr
Suite 306
Lewisburg, PA 17837-9350
Phone (570) 522-4110
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02533600 | Other | PA | CAPITAL BLUE CROSS |
| 29496 | Other | PA | HEALTH AMERICA |
| 725334 | Other | PA | GEISINGER |
| 02533600 | Other | PA | KEYSTONE |
| 1007498260054 | Medicaid | PA | |
| 001881627 | Other | PA | HIGHMARK BLUE SHIELD |
Other names
- EMSO Pathology Group
- WellSpan Laboratory Services
Other providers in Lewisburg, PA
- Evangelical Medical Services Organization
- Evangelical Medical Services Organization
- Evangelical Medical Services Organization
- Evangelical Medical Services Organization
- Evangelical Medical Services Organization
- Evangelical Medical Services Organization
- Evangelical Medical Services Organization
- Evangelical Medical Services Organization
- Evangelical Medical Services Organization
- Evangelical Medical Services Organization
All providers in Lewisburg, PA · Anatomic Pathology Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.