Basic Information
| Provider Information | |||||||||
| NPI: | 1578587986 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | YORK HOSPITAL | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | WELLSPAN YORK HOSPITAL INPATIENT PSYCH UNIT | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 785 5TH AVE STE 3 | ||||||||
| Address2: | |||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172014232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172639555 | ||||||||
| FaxNumber: | 7177096529 | ||||||||
| Practice Location | |||||||||
| Address1: | 1001 S GEORGE ST | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174033676 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178512345 | ||||||||
| FaxNumber: | 7178513020 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2006 | ||||||||
| LastUpdateDate: | 09/29/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | DIAMOND | ||||||||
| AuthorizedOfficialFirstName: | VICTORIA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | SR VP | ||||||||
| AuthorizedOfficialTelephone: | 7178513464 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 09/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251K00000X | N | Agencies | Public Health or Welfare | 261Q00000X | N | Ambulatory Health Care Facilities | Clinic/Center | 273R00000X | 250301 | PA | Y | Hospital Units | Psychiatric Unit |
ID Information
| ID | Type | State | Issuer | Description | 218968 | 01 | PA | HEALTHAMERICA | OTHER | 7926 | 01 | PA | GEISINGER | OTHER | 1027680 | 05 | PA | MEDICAID | 1565 | 01 | PA | HIGHMARK | OTHER | 000000081356 | 05 | PA | MEDICAID | 0001939000 | 05 | PA | MEDICAID | 08263 | 01 | PA | HEALTH PARTNERS | OTHER | 1564 | 01 | PA | HIGHMARK | OTHER | 000000066409 | 05 | PA | MEDICAID | 0942174000 | 01 | PA | KEYSTONE | OTHER | 229284 | 01 | PA | MAMSI, ALLIANCE, OPTIMUM | OTHER | 39S046 | 01 | PA | CAPITAL BLUE CROSS & KHP | OTHER | 1001965470030 | 05 | PA | MEDICAID | 390770 | 01 | PA | BLUE CROSS | OTHER | 60592 | 05 | PA | MEDICAID |