Provider Demographics
NPI:1588969307
Name:WELLSPAN SURGERY AND REHABILITATION HOSPITAL
Entity type:Organization
Organization Name:WELLSPAN SURGERY AND REHABILITATION HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR. VP AND CFO
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCZKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-442-3373
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:
Practice Address - Street 1:55 MONUMENT RD.
Practice Address - Street 2:WELLSPAN SURGERY AND REHABILITATION HOSPITAL-MRU
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403
Practice Address - Country:US
Practice Address - Phone:717-812-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WELLSPAN SURGERY AND REHABILITATION HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-26
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA259852OtherJOHNS HOPKINS HEALTHCARE
PA102704903Medicaid
PA1606592OtherGATEWAY
PA259852OtherJOHNS HOPKINS HEALTHCARE