Provider Demographics
NPI:1104882174
Name:CHAMBERSBURG HEALTH SERVICES
Entity type:Organization
Organization Name:CHAMBERSBURG HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP PHYSICIAN SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:LISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:HINCKLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-267-4764
Mailing Address - Street 1:785 5TH AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-709-6529
Practice Address - Street 1:260 N 7TH ST
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-1722
Practice Address - Country:US
Practice Address - Phone:717-262-4660
Practice Address - Fax:717-263-6251
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHAMBERSBURG HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-26
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007304950009Medicaid
PA1007304950005Medicaid