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Organization
LANCASTER GENERAL MEDICAL GROUP
Active
Organization
LANCASTER GENERAL MEDICAL GROUP
Active
Other names
Penn Medicine LGHP Family Medicine East Petersburg
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE A KENNEDY (VP FINANCIAL SERVICES)
(717) 544-5010
Entity
Organization
Contact information
Practice address
5665 MAIN ST, EAST PETERSBURG, PA 17520-1513
(717) 569-7011
(717) 569-8694
Mailing address
5665 MAIN ST, EAST PETERSBURG, PA 17520-1513
(717) 569-7011
(717) 569-8694
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03093300
CAPITAL BLUE CROSS
PA
05
—
1007327490104
—
PA
01
—
1518490
GATEWAY HEALTH PLAN
PA
01
—
174248
HIGHMARK BLUE SHIELD
PA
01
—
515156
AETNA HMO
PA
01
—
5634046
AETNA NON-HMO
PA
01
—
5702
AETNA CAP OFFICE#
PA
01
—
CN7460
RAILROAD MEDICARE
PA
01
—
S1QC
GEISINGER HEALTH PLAN
PA
Enumeration date
09/22/2005
Last updated
11/16/2020
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