LEBANON VALLEY FAMILY MEDICINE INC (NPI# 1639369804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639369804 |
| Entity Type | Organization |
| Organization Name | LEBANON VALLEY FAMILY MEDICINE INC |
| Practice Address |
1400 S Forge Rd Suite 1 Palmyra PA 17078-9519 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 7178381301 |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2012-10-22 |
| Authorized Official Name | KENNY HEINE (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 8586252990 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | MD027353 | PA | Suppliers |
| Street Address |
1400 S FORGE RD SUITE 1 |
| City | PALMYRA |
| State | PA |
| Zip Code | 17078-9519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326003849 | Lorri Kercher | Nurse Practitioner | 1400 S Forge Rd, Palmyra, PA 17078-9519 | 2006-04-18 |
| 1861984072 | Stephanie Ebersole | Physician Assistant | 1400 S Forge Rd, Palmyra, PA 17078-9519 | 2018-06-04 |
| 1902195654 | Amy Schreiber | Family Medicine | 1400 S Forge Rd, Suite 1, Palmyra, PA 17078-9513 | 2011-04-04 |
| 1740245042 | Ronica Montagna | Nurse Practitioner | 1400 S Forge Rd, Palmyra, PA 17078-9519 | 2006-04-19 |
| 1619932936 | Mark W Leach | Family Medicine | 1400 S Forge Rd, Palmyra, PA 17078-9519 | 2006-04-19 |
| 1508821836 | Jenny S Lee | Family Medicine | 1400 S Forge Rd, Palmyra, PA 17078-9519 | 2006-04-19 |
| 1184689648 | J Kent L Wagner | Family Medicine | 1400 S Forge Rd, Palmyra, PA 17078-9519 | 2006-04-19 |
| 1982669289 | Samuel F Rashid | Family Medicine | 1400 S Forge Rd, Palmyra, PA 17078-9519 | 2006-04-19 |
| 1467417733 | David A Keller | Family Medicine | 1400 S Forge Rd, Palmyra, PA 17078-9519 | 2006-04-19 |
| 1588629042 | John Patrick Welch | Family Medicine | 1400 S Forge Rd, Palmyra, PA 17078-9519 | 2006-04-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558916239 | Lolita Feld | Family Medicine | 941 Park Drive, Palmyra, PA 17078 | 2019-08-08 |
| 1508384736 | Kelly Renee Black | Specialist/Technologist | 503 North Chestnut Street, Palmyra, PA 17078 | 2017-09-08 |
| 1174857643 | Jason John Castro | Occupational Therapist | 1273 South Forge Road, Palmyra, PA 17078 | 2009-09-30 |
| 1962694174 | Timothy Ryan Corl | Optometrist | 2901 Horseshoe Pike, Palmyra, PA 17078 | 2007-08-11 |
| 1740349216 | Ck Kc Inc | Pharmacy | 22 East Main Street, Palmyra Pharmacy & Gift Shop, Palmyra, PA 17078 | 2006-12-08 |
| 1396839742 | Khanh T. Bui | Pharmacist | 30 W. Main Street, Palmyra, PA 17078 | 2006-10-02 |
| 1548369028 | Ck-kc Ltc, Inc | Pharmacy | 1200 Grubb Street, Palmyra, PA 17078 | 2006-09-21 |
| 1669846507 | Kelly Christine Morris | Occupational Therapist | 2880 Horseshoe Pike, Palmyra, PA 17078 | 2015-11-16 |
| 1003287558 | Corl Eyecare, LLC | Optometrist | 2901 Horseshoe Pike, Palmyra, PA 17078 | 2015-10-09 |
| 1972727238 | Philhaven Residential | Psychiatric Residential Treatment Facility | 231 E Main St, Palmyra, PA 17078 | 2007-04-11 |
| Find all providers in zip 17078 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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| 1144844507 | Diamond Drugs, Inc. | Non-Pharmacy Dispensing Site | 665 Kolter Dr, Indiana, PA 15701-3570 | 2020-06-02 |
| 1023655602 | Dedicated Pennsylvania Holding, LLC | Non-Pharmacy Dispensing Site | 330 W Oregon Ave # 170, Philadelphia, PA 19148-4723 | 2019-12-03 |
| 1275193336 | Q Pharma Inc | Non-Pharmacy Dispensing Site | 103 Nesbitt Rd, New Castle, PA 16105-3401 | 2019-06-19 |
| 1770141491 | R&r Eyewear Imports, Inc. | Non-Pharmacy Dispensing Site | 311 W Moreland Rd, Willow Grove, PA 19090-3107 | 2019-05-29 |
| 1174089858 | Centers for Advanced Urology, LLC | Non-Pharmacy Dispensing Site | 400 Davis Dr Ste 200a, Plymouth Meeting, PA 19462-1718 | 2019-02-18 |
| 1811469760 | Dermatology and Mohs Surgery Center PC | Non-Pharmacy Dispensing Site | 920 Lawn Ave Ste 6, Sellersville, PA 18960-1560 | 2018-12-17 |
| 1437624244 | Highpoint Pain & Rehabilitation Physicians | Non-Pharmacy Dispensing Site | 2 Village Road, Horsham, PA 19044 | 2018-10-08 |
| 1649768110 | Qpharma Inc | Non-Pharmacy Dispensing Site | 20 Highland Park Dr Ste 202, Uniontown, PA 15401-8968 | 2018-04-30 |
| 1215424536 | Q Pharma Inc | Non-Pharmacy Dispensing Site | 1321 Fifth Ave Ste 1, Mckeesport, PA 15132-2403 | 2018-04-23 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.