Organization
HANOVER HEALTH CORPORATION
Active
Organization
HANOVER HEALTH CORPORATION
Active
Other names
Hanover Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL W GASKINS (INTERIM CEO/CFO)
(717) 316-2153
Entity
Organization
Contact information
Practice address
300 HIGHLAND AVENUE, HANOVER, PA 17331-2297
(717) 637-3711
(717) 646-0188
Mailing address
300 HIGHLAND AVENUE, HANOVER, PA 17331-2297
(717) 316-3711
(717) 646-0188
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208600000X
Surgery Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
PA
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102387691
—
PA
05
—
PENDING
—
PA
Enumeration date
07/02/2009
Last updated
01/13/2016
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