Provider Demographics
NPI:1548311608
Name:MYERSTOWN FAMILY PRACTICE PC
Entity type:Organization
Organization Name:MYERSTOWN FAMILY PRACTICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-866-5755
Mailing Address - Street 1:431 W LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:MYERSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17067-2328
Mailing Address - Country:US
Mailing Address - Phone:717-866-5755
Mailing Address - Fax:
Practice Address - Street 1:431 W LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:MYERSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17067-2328
Practice Address - Country:US
Practice Address - Phone:717-866-5755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty