Basic Information
Provider Information
NPI: 1619296530
EntityType: 2
ReplacementNPI:  
OrganizationName: HOLY SPIRIT HOSPITAL
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 503 N 21ST ST
Address2:  
City: CAMP HILL
State: PA
PostalCode: 170112204
CountryCode: US
TelephoneNumber:  
FaxNumber: 7177632932
Practice Location
Address1: 503 N 21ST ST
Address2:  
City: CAMP HILL
State: PA
PostalCode: 170112204
CountryCode: US
TelephoneNumber: 7177632141
FaxNumber: 7177632932
Other Information
ProviderEnumerationDate: 05/18/2010
LastUpdateDate: 05/18/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: JONES
AuthorizedOfficialFirstName: JAMES
AuthorizedOfficialMiddleName: L
AuthorizedOfficialTitleorPosition: DIRECTOR OF PATIENT FINANCIAL SVCS
AuthorizedOfficialTelephone: 7177632888
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QM0801X340801PAY Ambulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)

ID Information
IDTypeStateIssuerDescription
100771881009305PA MEDICAID


Home