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Organization
LANCASTER GENERAL MEDICAL GROUP
Active
Organization
LANCASTER GENERAL MEDICAL GROUP
Active
Other names
Penn Medicine LGHP Family Medicine Susquehanna
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE A KENNEDY (VP FINANCIAL SERVICES)
(717) 544-5010
Entity
Organization
Contact information
Practice address
1159 RIVER RD, MARIETTA, PA 17547-1628
(717) 426-1131
(717) 426-2068
Mailing address
1159 RIVER RD, MARIETTA, PA 17547-1628
(717) 426-1131
(717) 426-2068
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02364600
CAPITAL BLUE CROSS
PA
05
—
1007327490088
—
PA
01
—
1019796
GATEWAY HEALTH PLAN
PA
01
—
430843
HIGHMARK BLUE SHIELD
PA
01
—
5026097
AETNA NON-HMO
PA
01
—
535947
AETNA HMO
PA
01
—
5761
AETNA CAP OFFICE#
PA
01
—
CN7614
RAILROAD MEDICARE
PA
01
—
S1QK
GEISINGER HEALTH PLAN
PA
Enumeration date
02/21/2006
Last updated
11/17/2020
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