Wellspan Family Medicine - West Cornwall

LBN: Good Samaritan Physician Services
Wellspan Family Medicine - West Cornwall is an health care organization with primary practice located at 101 Fairview Cir , Lebanon PA 17042-9581. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Good Samaritan Physician Services can be contacted via phone (717) 279-7303, or through Boger, Jody M via phone (717) 270-7780.

Contact Information

Primary practice address
101 Fairview Cir Lebanon PA 17042-9581
Fax: (717) 279-7471
Website:
Authorized official contact:
Name: Boger, Jody M

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1821429994
LBN Legal business name Good Samaritan Physician Services
DBA Doing business as Wellspan Family Medicine - West Cornwall
Authorized official Boger, Jody M
Entity Organization
Organization subpart 1 No
Enumeration date Nov 27th, 2013
Last updated Oct 20th, 2016 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821429994 NPPES
Pennsylvania MEDICAID 001864024

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