Basic Information
| Provider Information | |||||||||
| NPI: | 1568417962 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOSPITAL PHYSICIAN SPECIALISTS | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 7356 | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176047356 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103984000 | ||||||||
| FaxNumber: | 4103929289 | ||||||||
| Practice Location | |||||||||
| Address1: | 106 BOW ST | ||||||||
| Address2: | |||||||||
| City: | ELKTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 219215544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103984000 | ||||||||
| FaxNumber: | 4103929289 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2006 | ||||||||
| LastUpdateDate: | 05/05/2008 | ||||||||
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| AuthorizedOfficialLastName: | PIRRO | ||||||||
| AuthorizedOfficialFirstName: | ALFRED | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 4103984000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | KCE 4HO | 01 | MD | CAREFIRST GROUP NUMBER | OTHER | CJ3091 | 01 | MD | MEDICARE RAILROAD GROUP | OTHER | 368220000 | 05 | MD | MEDICAID |