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Organization
WELLSPAN MEDICAL GROUP
Active
Organization
WELLSPAN MEDICAL GROUP
Active
Other names
WellSpan Urgent Care
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTINA MOON (CREDENTIALING COORDINATOR)
(717) 851-1405
Entity
Organization
Contact information
Practice address
2250 E MARKET ST, YORK, PA 17402-2857
(717) 812-3940
(717) 812-3950
Mailing address
3421 CONCORD RD, YORK, PA 17402-9001
(717) 851-1405
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007721360262
—
PA
01
—
1874423
HIGHMARK WELLSPAN MG
PA
01
—
19WW
CAREFIRST BCBS
MD
01
—
20054647
AMERIHEALTH MERCY
PA
01
—
2736586000
AMERIHEALTH 65PA
PA
01
—
417T
GEISINGER
PA
01
—
50062674
CAPITAL BLUE CROSS
PA
01
—
7594870
AETNA
PA
01
—
800174
JOHN HOPKINS WELLSPAN MG
PA
01
—
CA3246
RAILROAD MEDICARE
PA
Enumeration date
10/03/2006
Last updated
08/29/2017
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