Provider Demographics
NPI:1891774006
Name:OFFICE OF THE CONTROLLER
Entity type:Organization
Organization Name:OFFICE OF THE CONTROLLER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FISCAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:KIMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-264-2715
Mailing Address - Street 1:201 FRANKLIN FARM LN
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17202-3060
Mailing Address - Country:US
Mailing Address - Phone:717-264-2715
Mailing Address - Fax:717-263-5887
Practice Address - Street 1:201 FRANKLIN FARM LN
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17202-3060
Practice Address - Country:US
Practice Address - Phone:717-264-2715
Practice Address - Fax:717-263-5887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-16
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA061302314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100764116Medicaid
PA100764116Medicaid