| NPI | 1598164337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EARL W EDWARDS Sole Member 717-747-3220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: PA MD427825) |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service (Licence: PA MD427825) |
| 261QM1300X Clinic/Center Multi-Specialty (Licence: PA MD427825) | |
| 261QP3300X Clinic/Center Pain (Licence: PA BE8901060) | |
| 302R00000X Health Maintenance Organization (Licence: PA MD427825) | |
| 305R00000X Preferred Provider Organization (Licence: PA MD427825) | |
| 305S00000X Point of Service (Licence: PA MD427825) | |
| Enumeration Date | 2014-08-18 |
| Last Update Date | 2016-01-20 |