Provider Demographics
NPI:1053386300
Name:THE MILTON S HERSHEY MEDICAL CENTER PHYSICIANS GROUP
Entity type:Organization
Organization Name:THE MILTON S HERSHEY MEDICAL CENTER PHYSICIANS GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKENNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:171-531-3979
Mailing Address - Street 1:PO BOX 858
Mailing Address - Street 2:MCA410
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-0858
Mailing Address - Country:US
Mailing Address - Phone:717-531-1159
Mailing Address - Fax:717-531-7269
Practice Address - Street 1:121 NYES RD
Practice Address - Street 2:SUITE A
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-3247
Practice Address - Country:US
Practice Address - Phone:800-243-1455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007452910082Medicaid
PA1007452910082Medicaid