| Mr Jeremy Alan Bullock, CRNA | |
|
252 S 4th St, Lebanon, PA 17042-6111 | |
| (717) 270-7500 | |
| (717) 228-1642 |
| Full Name | Mr Jeremy Alan Bullock |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 12 Years |
| Location | 252 S 4th St, Lebanon, Pennsylvania |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760825145 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | RN528480L (Pennsylvania) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Good Samaritan Hospital | Lebanon, PA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Wellspan Medical Group | 1951213115 | 2052 |
| Entity Name | Wellspan Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669770004 PECOS PAC ID: 1951213115 Enrollment ID: O20040220000815 |
| Entity Name | Ephrata Community Hospital |
|---|---|
| Entity Type | Part B Supplier - Hospital Department(s) |
| Entity Identifiers | NPI Number: 1063559912 PECOS PAC ID: 4981514445 Enrollment ID: O20091231000345 |
| Entity Name | Upmc Pinnacle Anesthesia Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730693979 PECOS PAC ID: 1951662980 Enrollment ID: O20180307001977 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Jeremy Alan Bullock, CRNA 601 Memory Ln, York, PA 17402-2231 Ph: (717) 851-1405 | Mr Jeremy Alan Bullock, CRNA 252 S 4th St, Lebanon, PA 17042-6111 Ph: (717) 270-7500 |
Ms. Lynee K Porter, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 912 Russell Drive, Lebanon, PA 17042 Phone: 717-272-9765 Fax: 717-272-9763 | |
Mrs. Wanda Garrett Perez, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 252 S 4th St, Lebanon, PA 17042 Phone: 717-270-7500 Fax: 717-228-1642 | |
Bridget Henderson, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 252 S 4th St, Lebanon, PA 17042 Phone: 717-228-1620 | |
Meredith Anne Dinger, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 252 S 4th St, Lebanon, PA 17042 Phone: 717-270-7500 | |
Kathleen Mattes-longo, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 252 South 4th St, Lebanon, PA 17042 Phone: 717-272-4104 | |
Mr. Zahid H Khan, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 252 S 4th St, Lebanon, PA 17042 Phone: 717-270-7500 Fax: 717-228-1642 | |
Kent Hepler, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 252 S 4th St, Lebanon, PA 17042 Phone: 717-270-7500 Fax: 717-228-1642 |