Masonic Villages of the Grand Lodge of Pennsylvania

Primary specialty

Inpatient HospiceTaxonomy code 315D00000X

Legal business name

MASONIC VILLAGES OF THE GRAND LODGE OF PENNSYLVANIA

Doing business as

Masonic Village Hospice

Practice address

581 Freemason Dr
Elizabethtown, PA 17022-3187

Phone

(717) 367-1121

Fax

(717) 367-5813

NPI assigned

Oct 30, 2012

Last updated

Oct 30, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. William J Prazenica

Title

Chief Financial Officer

Phone

(717) 367-1121

Specialties & licenses 1

Addresses

Other names 1

• Masonic Village Hospice Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Ashlar Home Health and Hospice Services, LLC

  • Community Based Hospice Care Agency
  • Elizabethtown, PA
  • NPI 1497280788

  Sold to, 2017-07-01

  CMS change of ownership

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351555200000",
    "number": "1932453867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MASONIC DR",
            "city": "ELIZABETHTOWN",
            "state": "PA",
            "postal_code": "170222199",
            "telephone_number": "717-367-1121",
            "fax_number": "717-367-5813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "581 FREEMASON DR",
            "city": "ELIZABETHTOWN",
            "state": "PA",
            "postal_code": "170223187",
            "telephone_number": "717-367-1121",
            "fax_number": "717-367-5813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASONIC VILLAGES OF THE GRAND LODGE OF PENNSYLVANIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-30",
        "last_updated": "2012-10-30",
        "status": "A",
        "authorized_official_last_name": "PRAZENICA",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "717-367-1121",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315D00000X",
            "taxonomy_group": "",
            "desc": "Hospice, Inpatient",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Masonic Village Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Zachary David Martin, PA-C
• Carolina Martinez
• Masonic Villages of the Grand Lodge of Pennsylvania (Masonic Village Pharmacy)
• Masonic Villages of the Grand Lodge of Pennsylvania (Masonic Village at Elizabethtown)
• Masonic Villages of the Grand Lodge of Pennsylvania (Masonic Village at Elizabethtown)
• Masonic Villages of the Grand Lodge of Pennsylvania
• John J Mast, M.D.
• Rana Lynn Mathias, DDS
• Brianne Alyssa Mayhue, OTR/L
• Margaret Lauren McFarland

• Inpatient Hospice in Elizabethtown, PA
• Providers in Elizabethtown, PA by specialty
• Inpatient Hospice in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.