Organization
LEBANON FAMILY HEALTH SERVICE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA WILLIAMS (VICE PRESIDENT OPERATIONS)
(717) 273-6741
Entity
Organization
Contact information
Practice address
615 CUMBERLAND ST, LEBANON, PA 17042-5233
(717) 273-6741
(717) 273-6337
Mailing address
615 CUMBERLAND ST, LEBANON, PA 17042-5233
(717) 273-6741
(717) 273-6337
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007146120003
—
PA
01
—
02821900
CAPITAL BLUE CROSS
PA
01
—
1503082
GATEWAY HEALTH PLAN
PA
01
—
656355
HIGHMARK BLUE SHIELD
PA
Enumeration date
10/09/2006
Last updated
02/22/2016
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