Provider Demographics
NPI:1730586843
Name:LANCASTER GENERAL MEDICAL GROUP
Entity type:Organization
Organization Name:LANCASTER GENERAL MEDICAL GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT FINANCIAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:A
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-544-5010
Mailing Address - Street 1:2110 HARRISBURG PIKE
Mailing Address - Street 2:BUILDING 2112 - SUITE 327
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2644
Mailing Address - Country:US
Mailing Address - Phone:717-544-3216
Mailing Address - Fax:717-544-3096
Practice Address - Street 1:2110 HARRISBURG PIKE
Practice Address - Street 2:BUILDING 2112 - SUITE 327
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2644
Practice Address - Country:US
Practice Address - Phone:717-544-3216
Practice Address - Fax:717-544-3096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-04
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty