Provider Demographics
NPI:1104088343
Name:DICKINSON COLLEGE HEALTH CENTER
Entity type:Organization
Organization Name:DICKINSON COLLEGE HEALTH CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR HEALTH CENTER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:FRANCES
Authorized Official - Last Name:ARTHUR
Authorized Official - Suffix:
Authorized Official - Credentials:RN CRNP
Authorized Official - Phone:717-245-1835
Mailing Address - Street 1:P O BOX 1773
Mailing Address - Street 2:28 N COLLEGE ST
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-2896
Mailing Address - Country:US
Mailing Address - Phone:717-245-1835
Mailing Address - Fax:717-245-1938
Practice Address - Street 1:CHERRY & LOUTHER ST
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-2896
Practice Address - Country:US
Practice Address - Phone:717-245-1835
Practice Address - Fax:717-245-1938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-30
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA261QS1000X, 261QF0050X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
No261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1001260500002Medicaid