# HANOVER FAMILY PRACTICE ASSOCIATES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235197104
- **Authorized official:** MRS. JULIE MOUL (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (717) 632-0774

## Contact information

- **Practice address:** 111 PENN ST, HANOVER, PA 17331-1929
- **Practice address phone:** (717) 632-4449
- **Mailing address:** 111 PENN ST, HANOVER, PA 17331-1929
- **Mailing address phone:** (717) 632-4449

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/02/2006
- **Last updated:** 02/03/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 02307000 | BLUE CROSS | PA |
| 01 | — | 0859603000 | INDEPENDANCE BLUE CROSS | PA |
| 05 | — | 1007518240013 | — | PA |
| 01 | — | 1520197 | GATEWAY | PA |
| 01 | — | 182943 | HEALTH AMERICA/ ASSURANCE | PA |
| 01 | — | 238893 | MAMSI | PA |
| 01 | — | 5337129 | AETNA | PA |
| 01 | — | 827916 | BLUE SHIELD | PA |
| 01 | — | CC6198 | PALMETTO | PA |