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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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