Provider Demographics
NPI:1487771028
Name:ADAMS HANOVER ENT, LLC
Entity type:Organization
Organization Name:ADAMS HANOVER ENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:MANNING
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:717-334-8171
Mailing Address - Street 1:508 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-2594
Mailing Address - Country:US
Mailing Address - Phone:717-334-8171
Mailing Address - Fax:717-334-8172
Practice Address - Street 1:508 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-2594
Practice Address - Country:US
Practice Address - Phone:717-334-8171
Practice Address - Fax:717-334-8172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD041451L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012145670002Medicaid
PA0012145670002Medicaid
PA001636Medicare ID - Type Unspecified