Provider Demographics
NPI:1699769828
Name:FOREST PARK HEALTH CENTER
Entity type:Organization
Organization Name:FOREST PARK HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AR MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GARRIANN
Authorized Official - Middle Name:
Authorized Official - Last Name:HEARN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-303-4926
Mailing Address - Street 1:1217 SLATE HILL RD
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-8012
Mailing Address - Country:US
Mailing Address - Phone:717-303-4926
Mailing Address - Fax:717-737-6763
Practice Address - Street 1:700 WALNUT BOTTOM RD
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-3631
Practice Address - Country:US
Practice Address - Phone:717-303-4926
Practice Address - Fax:717-737-6763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA60802314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007494880003Medicaid
PA395270Medicare ID - Type UnspecifiedFOREST PARK MEDICARE