Provider Demographics
NPI:1144064726
Name:OVERCOMER MEDICAL CLINIC
Entity type:Organization
Organization Name:OVERCOMER MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:272-202-8111
Mailing Address - Street 1:112 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LOCK HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17745-1246
Mailing Address - Country:US
Mailing Address - Phone:570-858-5720
Mailing Address - Fax:570-484-9450
Practice Address - Street 1:112 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LOCK HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17745-1246
Practice Address - Country:US
Practice Address - Phone:570-858-5720
Practice Address - Fax:570-484-9450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty