WELLSPAN FAMILY & SPORTS MEDICINE-COCALICO – NPI #1215257050
Clinic/Center

WELLSPAN FAMILY & SPORTS MEDICINE-COCALICO is an AHC clinic located in REINHOLDS, PA. NPPES has assigned the NPI number 1215257050 to WELLSPAN FAMILY & SPORTS MEDICINE-COCALICO on June 03, 2010. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “WELLSPAN FAMILY & SPORTS MEDICINE-COCALICO” is a dba name, the actual legal business name for this organization is NORTHERN LANCASTER COUNTY MEDICAL GROUP. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QP2300X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Primary Care

The NPI profile was previously updated about 11 years ago on Jun 15, 2015. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for WELLSPAN FAMILY & SPORTS MEDICINE-COCALICO below.

NPI Profile for
NORTHERN LANCASTER COUNTY MEDICAL GROUP

NPI Number
1215257050
Enumeration Date

(more than 16 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
NORTHERN LANCASTER COUNTY MEDICAL GROUP
Doing Business As (dba): WELLSPAN FAMILY & SPORTS MEDICINE-COCALICO
Primary location
30 W. SWARTZVILLE ROAD
SUITE 1
REINHOLDS, PA 17569
Phone: (717) 484-4347 Fax: (717) 484-0968
Mailing address
4131 OREGON PIKE
SUITE C
EPHRATA, PA 17522-9550
Phone: (717) 859-5161 Fax: (717) 859-5169
Organization Subpart
No
Authorized Official
CHARLES NOLL
VICE PRESIDENT
Phone: (717) 859-5161
Updated
Identifiers

Identifiers for WELLSPAN FAMILY & SPORTS MEDICINE-COCALICO

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDPA1013977730024
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QP2300X
- Clinic/Center / Primary Care (Primary)
207Q00000X
- Family Medicine

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.