Provider Demographics
NPI:1154418358
Name:LANCASTER GENERAL HOSPITAL
Entity type:Organization
Organization Name:LANCASTER GENERAL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:A
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-544-5658
Mailing Address - Street 1:540 N DUKE ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2374
Mailing Address - Country:US
Mailing Address - Phone:717-544-4950
Mailing Address - Fax:717-544-5964
Practice Address - Street 1:540 N DUKE ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2374
Practice Address - Country:US
Practice Address - Phone:717-544-4950
Practice Address - Fax:717-544-5964
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LANCASTER GENERAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-07
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50055738OtherCAPITAL BLUE CROSS
PA001604943OtherHIGHMARK BLUE SHIELD
PA1142435OtherAETNA-HMO
PA2288603000OtherAMERIHEALTH 65
PA7179762OtherAETNA-NON HMO