Provider Demographics
NPI:1902960495
Name:LANCASTER GENERAL HOSPITAL
Entity Type:Organization
Organization Name:LANCASTER GENERAL HOSPITAL
Other - Org Name:PENN MEDICINE LGH NURSE FAMILY PARTNERSHIP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT FINANCIAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-544-5010
Mailing Address - Street 1:555 N DUKE ST
Mailing Address - Street 2:PO BOX 3555
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2250
Mailing Address - Country:US
Mailing Address - Phone:717-544-5511
Mailing Address - Fax:
Practice Address - Street 1:531 N LIME ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2251
Practice Address - Country:US
Practice Address - Phone:717-544-4305
Practice Address - Fax:717-544-4312
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LANCASTER GENERAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-20
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100771175 0083Medicaid