Organization
WELLSPAN MEDICAL GROUP
Active
Other names
WellSpan Urgent Care
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTINA MOON (CREDENTIALING COORDINATOR)
(717) 851-1405
Entity
Organization
Contact information
Practice address
2250 E MARKET ST, YORK, PA 17402-2857
(717) 812-3940
(717) 812-3950
Mailing address
3421 CONCORD RD, YORK, PA 17402-9001
(717) 851-1405
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007721360262
—
PA
01
—
1874423
HIGHMARK WELLSPAN MG
PA
01
—
19WW
CAREFIRST BCBS
MD
01
—
20054647
AMERIHEALTH MERCY
PA
01
—
2736586000
AMERIHEALTH 65PA
PA
01
—
417T
GEISINGER
PA
01
—
50062674
CAPITAL BLUE CROSS
PA
01
—
7594870
AETNA
PA
01
—
800174
JOHN HOPKINS WELLSPAN MG
PA
01
—
CA3246
RAILROAD MEDICARE
PA
Enumeration date
10/03/2006
Last updated
08/29/2017
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