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120 RIDER AVENUE OPERATING COMPANY LP NPI 1992002505


NPI Information

NPI: 1992002505
Provider Name: 120 RIDER AVENUE OPERATING COMPANY, LP

Doing Business As: PEDIATRIC SPECIALTY CARE AT LANCASTER

Classification: Nursing Care - 251J00000X
Entity Type: Organization

CLIA Number: 39D2213696

Address:
120 RIDER AVE
LANCASTER, PA
ZIP 17603
Phone: (717) 394-0882
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120 RIDER AVENUE OPERATING COMPANY, LP is a nursing care in Lancaster, PA. The provider is a Nursing Care Agency is an entity that provides skilled nursing care through the services of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN), by employees, contracted individuals, or via a registry, in a variety of settings. The agency may engage in providing private duty nursing and/or staffing services. 120 RIDER AVENUE OPERATING COMPANY, LP NPI is 1992002505. The provider is registered as an organization entity type.
The provider Is Doing Business As Pediatric Specialty Care At Lancaster.

The provider's business location address is:

120 RIDER AVE
LANCASTER, PA
ZIP 17603-831
Phone: (717) 394-0882

The provider's authorized official is Gregory Hook .
The authorized official title is Chief Compliance Officer and has the following contact phone number (908) 236-8712.

The CLIA number assigned to this NPI record is 39D2213696 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/16/2011 and was last updated on 12/23/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251J00000XNursing Care328590PENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1328690OTHERPENNSYLVANIAPENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE
2328590OTHERPENNSYLVANIAPENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.