Organization
HANOVER HEALTH CORPORATION, INC.
Active
Other names
Carlos Medina, M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARILYN A. OLEJNIK (CHIEF FINANCIAL OFFICER)
(717) 637-3711
Entity
Organization
Contact information
Practice address
100 PENN ST, HANOVER, PA 17331-1956
(717) 632-3220
(717) 632-3220
Mailing address
300 HIGHLAND AVE, HANOVER, PA 17331-2297
(717) 633-3511
(717) 646-0188
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
PA
Enumeration date
02/13/2007
Last updated
08/22/2020
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