Masonic Villages of the Grand Lodge of Pennsylvania
NPI #1972856151 in Elizabethtown, Pennsylvania
Provider Information
- NPI Number
- 1972856151
- Entity Type
- Organization
- Organization Name
- Masonic Villages of the Grand Lodge of Pennsylvania
- Primary Specialty
- Clinical Medical Laboratory
- Enumeration Date
- Oct 25, 2012
- Last Updated
- May 1, 2023
Practice Location
- Address
- 581 FREEMASON DR
- City
- Elizabethtown
- State
- Pennsylvania
- ZIP Code
- 17022-3187
- Phone
- (717) 367-1121
Authorized Official
- Name
- MS. PAMELA FORMICA
- Title
- CHIEF FINANCIAL OFFICER
- Phone
- (717) 367-1121
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinical Medical Laboratory |
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