| Lebanon Ridge Community Health | |
|
840 Norman Dr Lebanon PA 17042-7444 | |
| (717) 272-2700 | |
| (717) 272-2757 |
| Full Name | Lebanon Ridge Community Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 840 Norman Dr, Lebanon, Pennsylvania |
| Authorized Official Name and Position | Jacqueline Concepcion (CEO) |
| Authorized Official Contact | 7173544711 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lebanon Ridge Community Health 584 Springville Rd New Holland PA 17557-9564 Ph: (717) 354-4711 | Lebanon Ridge Community Health 840 Norman Dr Lebanon PA 17042-7444 Ph: (717) 272-2700 |
| NPI Number | 1730488388 |
|---|---|
| Provider Enumeration Date | 03/22/2011 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 8123914322 |
|---|---|
| Medicare Enrollment ID | O20111219000660 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730488388 | NPI | - | NPPES |
| 100761419 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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