Organization
CONESTOGA EMERGENCY PHYSICIANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL HARRIS MD (PRESIDENT)
(469) 401-2386
Entity
Organization
Contact information
Practice address
250 COLLEGE AVE, LANCASTER, PA 17603-3363
(717) 291-8211
(717) 291-8090
Mailing address
232 LAKESIDE DR, HORSHAM, PA 19044-2319
(800) 247-8060
(215) 957-2875
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019617990001
—
PA
01
—
50020594
BLUE CROSS
PA
01
—
CO1483119
BLUE SHIELD
PA
Enumeration date
05/09/2006
Last updated
12/22/2013
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