# H.B.P.A. MEDICAL CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Jeanette Johnston H.B.P.A Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144589953
- **Authorized official:** MR. TODD MOSTOLLER (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (717) 469-2970

## Contact information

- **Practice address:** 1111 FIRE HOUSE RD, GRANTVILLE, PA 17028
- **Practice address phone:** (717) 469-2970
- **Practice address fax:** (717) 469-7714
- **Mailing address:** 1111 FIREHOUSE RD., GRANTVILLE, PA 17028
- **Mailing address phone:** (717) 469-2970
- **Mailing address fax:** (717) 469-7714

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | RN163-298L | PA | — |
| 207Q00000X | Family Medicine Physician | OS-006156-L | PA | Yes |

## Other

- **Enumeration date:** 05/14/2012
- **Last updated:** 05/14/2012