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Organization
LANCASTER GENERAL MEDICAL GROUP
Active
Organization
LANCASTER GENERAL MEDICAL GROUP
Active
Parent organization
LANCASTER GENERAL MEDICAL GROUP
Other names
Penn Medicine LGHP Family Medicine Lititz
Organization subpart
Yes
Provider details
NPI number
Legal business name
LANCASTER GENERAL MEDICAL GROUP
Authorized official
DENISE KENNEDY (VICE PRESIDENT FINANCIAL SERVICES)
(717) 544-5010
Entity
Organization
Contact information
Practice address
562 WEST 2ND AVENUE, LITITZ, PA 17543-1816
(717) 626-2167
(717) 626-1915
Mailing address
562 WEST 2ND AVENUE, LITITZ, PA 17543-1816
(717) 626-2167
(717) 626-1915
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03093600
CAPITAL BLUE CROSS
PA
05
—
1007327490074
—
PA
01
—
128360
HIGHMARK BLUE SHIELD
PA
01
—
1294
AETNA HMO
PA
01
—
1518494
GATEWAY HEALTH PLAN
PA
01
—
5913568
AETNA NON-HMO
PA
01
—
85047
AETNA CAP OFFICE#
PA
01
—
CC3129
RAILROAD MEDICARE
PA
01
—
S1QG
GEISINGER HEALTH PLAN
PA
Enumeration date
11/21/2005
Last updated
11/16/2020
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