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Organization
LANCASTER GENERAL MEDICAL GROUP
Active
Organization
LANCASTER GENERAL MEDICAL GROUP
Active
Other names
Penn Medicine LGHP Family Medicine Manheim
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE KENNEDY (VICE PRESIDENT FINANCIAL SERVICES)
(717) 544-5010
Entity
Organization
Contact information
Practice address
700 LANCASTER RD, MANHEIM, PA 17545-2314
(717) 665-2496
(717) 665-6345
Mailing address
700 LANCASTER RD, MANHEIM, PA 17545-2314
(717) 665-2496
(717) 665-6345
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03128600
CAPITAL BLUE CROSS
PA
05
—
1007327490073
—
PA
01
—
1518492
GATEWAY HEALTH PLAN
PA
01
—
558423
AETNA HMO
PA
01
—
5897045
AETNA NON-HMO
PA
01
—
725913
HIGHMARK BLUE SHIELD
PA
01
—
85048
AETNA CAP OFFICE#
PA
01
—
CD8099
RAILROAD MEDICARE
PA
01
—
S1QH
GEISINGER HEALTH PLAN
PA
Enumeration date
11/21/2005
Last updated
11/17/2020
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