Basic Information
| Provider Information | |||||||||
| NPI: | 1881756484 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | YORK HOSPITAL | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | THOMAS HART FAMILY PRACTICE CENTER | ||||||||
| 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: | 174052507 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178512521 | ||||||||
| FaxNumber: | 7178513535 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2006 | ||||||||
| LastUpdateDate: | 09/29/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | DIAMOND | ||||||||
| AuthorizedOfficialFirstName: | VICTORIA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | VP | ||||||||
| AuthorizedOfficialTelephone: | 7178513464 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 09/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 207R00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 208VP0000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine | 363L00000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 282N00000X | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 100196547 0081 | 05 | PA | MEDICAID | 1001965470062 | 05 | PA | MEDICAID | 5998132 | 01 | PA | AETNA | OTHER | 82755 | 01 | PA | UNISON OBGYN | OTHER | S1FE | 01 | PA | GEISINGER | OTHER | 03192200 | 01 | PA | CAPITAL BLUE CROSS | OTHER | 1377740 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 20070647 | 01 | PA | AMERIHEALTH CARITAS PA - WMG - THFPC | OTHER | 1143594 | 01 | PA | AMERIHEALTH MERCY | OTHER | 82133 | 01 | PA | UNISON PCP | OTHER | F2PW | 01 | MD | MARYLAND BCBS CAREFIRST | OTHER | 1504131 | 01 | PA | GATEWAY | OTHER | CI1598 | 01 | PA | RAILROAD MEDICARE | OTHER |