Organization · NPI-2

Gaudenzia INC

Clinic/Center · Harrisburg, PA

NPI number1467577619
StatusActive
Last updated in NPPESDec 13, 2021

Details

NPI
1467577619
Entity type
Organization (NPI-2)
Legal business name
Gaudenzia INC
Organization subpart
No
Enumeration date
Mar 20, 2007
Certification date
Dec 13, 2021
Last updated
Dec 13, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center227035PAYes

Other names

  • Gaudenzia Harrisburg Outpatient Services (Other Name)

Practice location

2039 N 2nd St
Harrisburg, PA 17102-2103

Phone 717-233-3424 · Fax 717-233-6399

Mailing address

106 W Main St
Norristown, PA 19401-4716

Phone 610-239-9600 · Fax 610-275-7025

Authorized official

Mike Williams
Sr. Contracting Manager
4843383731

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