Provider Demographics
NPI:1306257985
Name:LANCASTER HEMATOLOGY ONCOLOGY CARE
Entity type:Organization
Organization Name:LANCASTER HEMATOLOGY ONCOLOGY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SITE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELLISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:KERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-735-3738
Mailing Address - Street 1:233 COLLEGE AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-3372
Mailing Address - Country:US
Mailing Address - Phone:717-735-3738
Mailing Address - Fax:
Practice Address - Street 1:233 COLLEGE AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-3372
Practice Address - Country:US
Practice Address - Phone:717-735-3738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHYSICIANS' ALLIANCE, LTC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-05-16
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS012014207RX0202X
PAMD057078L207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG292266Medicare UPIN
I131698Medicare UPIN