PROVIDER2015DIRECTORY

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1 PROVIDER2015DIRECTORY () SecureChoiceSM SecureChoice SM is brought to you by Keystone Health Plan Central, a Capital BlueCross company. Capital BlueCross is an Independent Licensee of the BlueCross BlueShield Association

2 The following section lists network hospitals. Preauthorization Requirements HOSPITALS All acute care inpatient services, except for emergency services and admissions for delivery, must be preauthorized. Preauthorization for SecureChoice SM Members is an approval process used to determine member eligibility, benefit coverage and medical necessity of proposed services at the time of the request. You may ask your provider if the service requires preauthorization. Network providers are responsible for knowing which services require preauthorization and for obtaining preauthorization from Keystone Health Plan Central or its designated representative before providing the service. Please note: The emergency room (ER), anesthesia, radiology and pathology physicians working in some hospitals may not be participating (network) providers. If you receive covered ER, anesthesia, radiology and/or pathology services in a participating hospital, you may be balance billed by the treating physician(s). Important Notes This directory is accurate only as of the date the information was generated for this printing. To check the most current participation status of any particular provider, visit our website at capbluecross.com/healthypa or call the toll-free number on your ID card. You may also contact our Customer Service Department for SecureChoice SM Members at (TTY 711), Monday through Friday, 8:00 AM to 6:00 PM, or contact the provider directly to verify their participation in SecureChoice SM. If you have questions about your benefits or any other aspect of your health care coverage, please call the toll-free number on your ID card or contact our Customer Service Department for SecureChoice SM Members at (TTY 711), Monday through Friday, 8:00 AM to 6:00 PM. After normal business hours, you may leave a voice mail message and a Customer Service Representative will return your call during the next business day. Always present your Member identification card each time you seek medical services. For detailed information concerning your benefits, please refer to your Member Handbook. Page 329

3 Acute Care Hospital Acute Care Hospital Reading Hospital and Medical CBC # NPI/Ref # th Ave & Spruce St Reading, PA Phone: (610) Fax: (610) St Joseph Medical CBC # NPI/Ref # Bernville Rd Reading, PA Phone: (610) Fax: (610) Surgical Institute of Reading CBC # NPI/Ref # Century Blvd Phone: (610) Fax: (610) Centre Mount Nittany Medical CBC # NPI/Ref # E Park Ave State College, PA Phone: (814) Fax: (814) Chester Brandywine Hospital CBC # NPI/Ref # Reeceville Rd Coatesville, PA Phone: (610) Fax: (610) Phoenixville Hospital CBC # NPI/Ref # Nutt Rd Phoenixville, PA Phone: (610) Fax: (610) Columbia Berwick Hospital CBC # NPI/Ref # E 16th St Berwick, PA Phone: (570) Fax: (570) Carlisle Regional Medical CBC # NPI/Ref # Alexander Spring Rd Carlisle, PA Phone: (717) Fax: (717) Holy Spirit Hospital CBC # NPI/Ref # N 21st St Phone: (717) Fax: (717) PinnacleHealth Hospitals CBC # NPI/Ref # West Shore Campus 1995 Technology Pkwy Mechanicsburg, PA Phone: (717) Milton S Hershey Medical (The) CBC # NPI/Ref # University Dr Hershey, PA Phone: (717) Fax: (717) PinnacleHealth Hospitals CBC # NPI/Ref # Counity Campus 4300 Londonderry Rd Phone: (717) Harrisburg Campus 111 S Front St Harrisburg, PA Phone: (717) Fax: (717) Chambersburg Hospital CBC # NPI/Ref # N 7th St Phone: (717) Fax: (717) Waynesboro Hospital CBC # NPI/Ref # E Main St Waynesboro, PA Phone: (717) Fax: (717) Fulton Fulton County Medical CBC # NPI/Ref # Peach Orchard Rd Mc Connellsburg, PA Phone: (717) Fax: (717) Heart of Regional Medical CBC # NPI/Ref # Highlands Dr Lititz, PA Phone: (717) Fax: (717) General Hospital CBC # NPI/Ref # N Duke St, PA Phone: (717) Fax: (717) Regional Medical CBC # NPI/Ref # College Ave, PA Phone: (717) Fax: (717) The Good Samaritan Hospital of PA CBC # NPI/Ref # th & Walnut Sts, PA Phone: (717) Fax: (717) Valley Hospital CBC # NPI/Ref # S Cedar Crest Blvd Allentown, PA Phone: (610) Fax: (484) Sacred Heart Hospital CBC # NPI/Ref # Chew St Allentown, PA Phone: (610) Fax: (610) St Lukes Hospital - Allentown Campus CBC # NPI/Ref # Hamilton St Phone: (610) Fax: (610) Surgical Specialty Ctr at Coordinated Health (The) CBC # NPI/Ref # N Cedar Crest Blvd Phone: (610) Montgomery Pottstown Memorial Medical CBC # NPI/Ref # E High St Pottstown, PA Phone: (610) Fax: (610) Coordinated Health Orthopedic Hospital LLC CBC # NPI/Ref # Highland Ave Bethlehem, PA Phone: (610) Fax: (610) Easton Hospital CBC # NPI/Ref # S 21st St Easton, PA Phone: (610) Fax: (610) Valley Hospital - Muhlenberg CBC # NPI/Ref # Schoenersville Rd Phone: (610) Fax: (484) St Lukes Hospital CBC # NPI/Ref # Ostrum St Bethlehem, PA Phone: (610) Fax: (610) St Lukes Hospital - Anderson CBC # NPI/Ref # Riverside Cir Easton, PA Phone: (484) Northumberland Sunbury Counity Hospital CBC # NPI/Ref # N 11th St Sunbury, PA Phone: (570) Fax: (570) Schuylkill Schuylkill Medical - East Norwegian Street CBC # NPI/Ref # E Norwegian St Pottsville, PA Phone: (570) Fax: (570) Schuylkill Medical - South Jackson Street CBC # NPI/Ref # S Jackson St Pottsville, PA Phone: (570) Fax: (570) St Lukes Miners Memorial Hospital CBC # NPI/Ref # W Ruddle St Coaldale, PA Phone: (570) Fax: (570) Union Evangelical Counity Hospital CBC # NPI/Ref # Hospital Dr Lewisburg, PA Phone: (570) Fax: (570) Hanover Hospital CBC # NPI/Ref # Highland Ave Hanover, PA Phone: (717) Fax: (717) Memorial Hospital CBC # NPI/Ref # S Belmont St, PA Phone: (717) Fax: (717) OSS Orthopaedic Hospital LLC CBC # NPI/Ref # Powder Mill Rd, PA Phone: (717) Fax: (717) Acute Care Hospital Outpatient Site Pottstown Memorial Medical CBC # NPI/Ref # Boyertown Rehab & Diagnostic Svcs 23 N Walnut St Boyertown, PA Phone: (610) St Joseph Medical CBC # NPI/Ref # St Jos RHN at Broadcasting 2610 Keiser Blvd Phone: (610) Fax: (610) St Jos RHN at Heritage of Green Hills 200 Tranquility Ln Reading, PA Phone: (484) Fax: (610) St Joseph Health Network at Spring Ridge 2605 Keiser Blvd 2nd Fl Phone: (610) Chester General Hospital CBC # NPI/Ref # General Health Ctr- Parkesburg 950 S Octorara Trl Parkesburg, PA Phone: (610) Fax: (610) St Joseph Medical CBC # NPI/Ref # St Joseph Health Network at Elverson 45 S Pine St Elverson, PA Phone: (610) Fax: (610) Holy Spirit Hospital CBC # NPI/Ref # Holy Spirit Cardiovascular Imaging 101 Erford Rd Ste 101 Phone: (717) Fax: (717) Holy Spirit Carlisle Imaging 1211 Forge Rd Ste 400 Carlisle, PA Phone: (717) Fax: (717) Holy Spirit Magnetic Imaging 4665 E Trindle Rd Mechanicsburg, PA Phone: (717) Fax: (717) HSH Laboratory at Century Dr 856 Century Dr Mechanicsburg, PA Phone: (717) PinnacleHealth Hospitals CBC # NPI/Ref # Lowther St Lemoyne, PA Phone: (717) Fax: (717) Fredricksen Outpatient Ctr 2015 Technology Pkwy Mechanicsburg, PA Phone: (717) PH Cardiac & Pulmonary Rehab - West 1000 N Front St Ste 102 Wormleysburg, PA Phone: (717) Fax: (717) HOSPITALS For a list of services offered at Acute Care Hospital Outpatient Sites, please contact the facility directly. Handicap Accessible Page 331

4 Acute Care Hospital Outpatient Site HOSPITALS PH Imaging at Fredericksen OP Ctr 2015 Technology Pkwy Mechanicsburg, PA Phone: (717) Fax: (717) PH Lab Svcs at Belvedere Med Ctr 850 Walnut Bottom Rd Ste 104 Carlisle, PA Phone: (717) Fax: (717) PH Lab Svcs at Fredericksen OP Ctr 2015 Technology Pkwy Mechanicsburg, PA Phone: (717) Fax: (717) PH Sleep Ctr at Fredericksen OP Ctr 2015 Technology Pkwy Mechanicsburg, PA Phone: (717) PinnacleHealth Cardiovascular Institute 1000 N Front St Wormleysburg, PA Phone: (717) Fax: (717) PinnacleHealth Cardiovascular Institute 360 Alexander Spring Rd Carlisle, PA Phone: (717) Fax: (717) PinnacleHealth Cardiovascular Institute 900 Century Dr Ste 100 Mechanicsburg, PA Phone: (717) Fax: (717) PinnacleHealth Imaging at Silver Spring 21 Waterford Dr Mechanicsburg, PA Phone: (717) Fax: (717) PinnacleHealth Imaging at West Shore 240 Grandview Ave Phone: (717) Fax: (717) PinnacleHealth Lab Srvcs at Silver Sprg 21 Waterford Dr Mechanicsburg, PA Phone: (717) Fax: (717) PinnacleHealth Lab Svcs at Lemoyne 3 Walnut St Ste 100 Lemoyne, PA Phone: (717) Fax: (717) PinnacleHealth Ortenzio Cancer Ctr 2035 Technology Pkwy Mechanicsburg, PA Phone: (717) Fax: (717) PinnacleHealth PT of Camp Hill 3 Walnut St Ste 110 Lemoyne, PA Phone: (717) Fax: (717) PinnacleHlth PT at Fredricksen OP Ctr 2015 Technology Pkwy Mechanicsburg, PA Phone: (717) Fax: (717) Women's Cancer Ctr - PinnacleHealth Hosp 2035 Technology Pkwy Mechanicsburg, PA Phone: (717) Fax: (717) Holy Spirit Hospital CBC # NPI/Ref # Holy Spirit Cardiovascular Imaging 5 Capital Dr Ste 203 Phone: (717) Fax: (717) Holy Spirit Imaging Ctr East 4230 Crums Mill Rd Phone: (717) HSH East Shore Laboratory 2808 Old Post Rd Phone: (717) PinnacleHealth Hospitals CBC # NPI/Ref # Adams Dr Huelstown, PA Phone: (717) Fax: (717) Capital Region Vein Ctr 2808 Old Post Rd Phone: (717) PH Cardiac & Pulmonary Rehab - East 2808 Old Post Rd Phone: (717) Fax: (717) PH Sleep Ctr at Bloom OP Ctr 4310 Londonderry Rd Phone: (717) PinnacleHealth Bloom Diagnostic Ctr 4310 Londonderry Rd Phone: (866) PinnacleHealth Cardiovascular Institute 2808 Old Post Rd Phone: (717) Fax: (717) PinnacleHealth Imaging at Hershey 32 Northeast Dr Ste 101 Hershey, PA Phone: (717) Fax: (717) PinnacleHealth Imaging at Huelstown 8105 Adams Dr Ste A Huelstown, PA Phone: (717) Fax: (717) PinnacleHealth Imaging at Linglestown 2808 Old Post Rd Phone: (717) Fax: (717) PinnacleHealth Imaging at Lower Paxton 2310 Patton Rd Harrisburg, PA Phone: (717) Fax: (717) PinnacleHealth Imaging at Middletown 1025 Harrisburg Pike Middletown, PA Phone: (717) Fax: (717) PinnacleHealth Imaging at Millersburg 1000 Evelyn Dr Millersburg, PA Phone: (717) Fax: (717) PinnacleHealth Imaging at Union Deposit 4518 Union Deposit Rd Harrisburg, PA Phone: (717) Fax: (717) PinnacleHealth Lab Svcs at Huelstown 8105 Adams Dr Ste A Huelstown, PA Phone: (717) Fax: (717) PinnacleHealth Lab Svcs at Lower Paxton 2310 Patton Rd Ste B Harrisburg, PA Phone: (717) Fax: (717) PinnacleHealth Lab Svcs at Middletown 1025 Harrisburg Pike Middletown, PA Phone: (717) Fax: (717) PinnacleHealth Lab Svcs at Millersburg 1000 Evelyn Dr Millersburg, PA Phone: (717) Fax: (717) PinnacleHealth Lab Svcs at Old Post Road 2808 Old Post Rd Phone: (717) Fax: (717) PinnacleHealth Medical Sciences Pavilion 4300 Londonderry Rd Phone: (717) PinnacleHealth PT at Middletown 1025 Harrisburg Pike Middletown, PA Phone: (717) Fax: (717) PinnacleHealth PT of Elizabethville 125 E Main St Elizabethville, PA Phone: (717) Fax: (717) Polyclinic Campus 2501 N 3rd St Phone: (717) Pulmonary Nodule Clinic Brady Bldg 205 S Front St Harrisburg, PA Phone: (717) Fax: (717) General Hospital CBC # NPI/Ref # N 7th St Columbia, PA Phone: (717) Fax: (717) Columbia Health Ctr 631 Poplar St Columbia, PA Phone: (717) Fax: (717) Crooked Oak Medical Svcs 1671 Crooked Oak Dr, PA Phone: (717) Fax: (717) Kissel Hill Health Ctr 51 Peters Rd Lititz, PA Phone: (717) Fax: (717) General Norlanco 424 Cloverleaf Rd Elizabethtown, PA Phone: (717) Fax: (717) General Women's & Babies Hosp 690 Good Dr, PA Phone: (717) Fax: (717) Walter L Aument Family Hlth Ctr 317 S Chestnut St Quarryville, PA Phone: (717) Fax: (717) Willow Lakes Medical Svcs 222 Willow Vly Lakes Dr Willow Street, PA Phone: (717) Fax: (717) PinnacleHealth Hospitals CBC # NPI/Ref # PH Comp Hand & Upper Extremity Ctr 1575 Highlands Dr Ste 202 Lititz, PA Phone: (717) Fax: (717) The Good Samaritan Hospital of PA CBC # NPI/Ref # GSH Ambulatory Ctr 1400 S Forge Rd Palmyra, PA Phone: (717) Fax: (717) GSH Cardiovascular Diagnostic Ctr 781 Norman Dr, PA Phone: (717) GSH Ctr Wound Care Hyperbaric Med 840 Tuck St, PA Phone: (717) Fax: (717) GSH OP Surgical Ctr 830 Tuck St, PA Phone: (717) Fax: (717) GSH OP Diagnostic Ctr 297 W Lincoln Ave Myerstown, PA Phone: (717) Fax: (717) GSH OP Physical Therapy 1400 S Forge Rd Palmyra, PA Phone: (717) Fax: (717) GSH OP Physical Therapy 950 Isabel Dr Quentin Cir, PA Phone: (717) Fax: (717) GSH OP Radiology Ctr 805 Helen Dr, PA Phone: (717) Fax: (717) GSH Satellite Jonestown Ctr 100 Queen St Jonestown, PA Phone: (717) Fax: (717) Valley Hospital CBC # NPI/Ref # for Orthopedic Medicine 4815 Tilghman St Phone: (610) Montgomery Pottstown Memorial Medical CBC # NPI/Ref # Careplex 81 Robinson St Pottstown, PA Phone: (610) Pottstown Scanning & Treatment Ctr 1611 Medical Dr Pottstown, PA Phone: (610) Perry Holy Spirit Hospital CBC # NPI/Ref # Duncannon Xray & Maography 510 New Bloomfield Rd Duncannon, PA Phone: (717) PinnacleHealth Hospitals CBC # NPI/Ref # PinnacleHealth Cardiovascular Institute 300 Bretz Ct Newport, PA Phone: (717) Fax: (717) PinnacleHealth Imaging at Newport 300 Bretz Ct Newport, PA Phone: (717) Fax: (717) PinnacleHealth Lab Svcs at Newport 300 Bretz Ct Newport, PA Phone: (717) Fax: (717) Memorial Hospital CBC # NPI/Ref # th Ave, PA Phone: (717) Fax: (717) Greenbriar Medical Ctr 520 Greenbriar Rd, PA Phone: (717) PinnacleHealth Hospitals CBC # NPI/Ref # Trinity Dr E Ste 10 Dillsburg, PA Phone: (717) Fax: (717) PinnacleHealth Imaging at Dillsburg 1 Trinity Dr E Dillsburg, PA Phone: (717) Fax: (717) PinnacleHealth Lab Svcs at Dillsburg 1 Trinity Dr E Ste 130 Dillsburg, PA Phone: (717) Fax: (717) Handicap Accessible Page 332 For a list of services offered at Acute Care Hospital Outpatient Sites, please contact the facility directly.

5 Rehabilitation Unit Long Term Acute Care Hospital Select Specialty Hospital - Central PA-Harrisburg CBC # NPI/Ref # S Front St Alex Grass Bldg 5th Fl Harrisburg, PA Phone: (717) Fax: (717) Montour Select Specialty Hospital - Danville CBC # NPI/Ref # Bush Pavilion 3rd Fl MC N Academy Ave Danville, PA Phone: (570) Fax: (570) Rehabilitation Hospital Good Shepherd Rehabilitation Hospital CBC # NPI/Ref # Good Shep O/P Rehab - Blandon 850 Golden Dr Ste 13/14 Blandon, PA Phone: (610) Fax: (610) Good Shep O/P Rehab - Kutztown 333 Normal Ave Kutztown, PA Phone: (610) Fax: (610) Good Shep PT - Hamburg 500 Hawk Dr Ste 2A Hamburg, PA Phone: (610) Fax: (610) HEALTHSOUTH Reading Rehabilitation Hospital CBC # NPI/Ref # Morgantown Rd Reading, PA Phone: (610) Fax: (610) Bucks Good Shepherd Rehabilitation Hospital CBC # NPI/Ref # Good Shep O/P Rehab - Quakertown 134 Mill Rd Quakertown, PA Phone: (215) Fax: (610) Carbon Good Shepherd Rehabilitation Hospital CBC # NPI/Ref # Good Shep O/P Rehab - Palmerton 3295 Forest Inn Rd Palmerton, PA Phone: (610) Fax: (610) Centre HEALTHSOUTH Nittany Valley Rehabilitation Hospital CBC # NPI/Ref # W College Ave Pleasant Gap, PA Phone: (814) Fax: (814) Columbia Geisinger HEALTHSOUTH Rehabilitation Hospital CBC # NPI/Ref # Glen Ave Ste 101 Bloomsburg, PA Phone: (570) Fax: (570) Geis HEALTHSOUTH Rehab Ctr Bloomsburg 415 Central Rd Bloomsburg, PA Phone: (570) Fax: (570) Geis HEALTHSOUTH Rehab Ctr of Berwick 2202 W Front St Berwick, PA Phone: (570) Fax: (570) HEALTHSOUTH Rehabilitation of Mechanicsburg CBC # NPI/Ref # Blvd Mechanicsburg, PA Phone: (717) Fax: (717) Helen M Simpson Rehabilitation Hospital CBC # NPI/Ref # Londonderry Rd Phone: (717) Fax: (717) Penn State Hershey Rehabilitation LLC CBC # NPI/Ref # Old W Chocolate Ave Huelstown, PA Phone: (717) Fax: (717) Rehabilitation Hospital CBC # NPI/Ref # Good Dr, PA Phone: (717) Fax: (717) Good Shepherd Rehabilitation Hospital CBC # NPI/Ref # S 5th St Phone: (610) Fax: (610) Good Shep O/P Rehab - Cedar Crest 1243 S Cedar Crest Blvd Phone: (610) Fax: (610) Good Shep O/P Rehab - Valley 4883 Rte 309 Valley, PA Phone: (610) Fax: (610) Good Shep O/P Rehab - Hlth & Tech Ctr 850 S 5th St Phone: (610) Fax: (610) Good Shep O/P Rehab - Macungie 6465 Village Ln Ste 5 Macungie, PA Phone: (484) Fax: (610) Good Shep O/P Rehab - Ortho & Hand Unit 850 S 5th St Phone: (610) Fax: (610) Good Shep O/P Rehab - Pediatrics Hlth 850 S 5th St Phone: (610) Fax: (610) Good Shep O/P Rehab - Schnecksville 4110 Independence Dr Rear Ste 200 Schnecksville, PA Phone: (610) Fax: (610) Good Shep O/P Therapy th St Whitehall, PA Phone: (610) Fax: (610) Good Shep O/P Therapy 4851 Saucon Creek Rd Valley, PA Phone: (610) Fax: (610) Good Shep PT - Coopersburg 101 S Main St 3rd Fl Coopersburg, PA Phone: (610) Fax: (610) Good Shep Rehab 5649 Wynnwood Dr Rte 145 Ste 103 Laurys Station, PA Phone: (610) Fax: (610) Mifflin HEALTHSOUTH Nittany Valley Rehabilitation Hospital CBC # NPI/Ref # HEALTHSOUTH O/P Rehab Ctr 99 Juniata St Lewistown, PA Phone: (717) Fax: (717) Monroe Good Shepherd Rehabilitation Hospital CBC # NPI/Ref # Good Shep O/P Rehab - Stroudsburg 1619 N 9th St Ste 4 Stroudsburg, PA Phone: (570) Fax: (610) Good Shep Rehab - Pocono Med Ctr 206 E Brown St East Stroudsburg, PA Phone: (570) Fax: (570) Montgomery Good Shepherd Rehabilitation Hospital CBC # NPI/Ref # Good Shep PT - East Greenville 622 Gravel Pike Ste 110 East Greenville, PA Phone: (215) Fax: (610) Good Shep PT - Souderton 4036 Bethlehem Pike Telford, PA Phone: (215) Fax: (610) HEALTHSOUTH Reading Rehabilitation Hospital CBC # NPI/Ref # HEALTHSOUTH Rehab Ctr - Pottstown 1566 Medical Dr Ste 104 Pottstown, PA Phone: (610) Fax: (610) Montour Geisinger HEALTHSOUTH Rehabilitation Hospital CBC # NPI/Ref # Rehab Ln Danville, PA Phone: (570) Fax: (570) Geis HEALTHSOUTH Rehab Ctr of Danville 109 Woodbine Ln Danville, PA Phone: (570) Fax: (570) Good Shepherd Rehabilitation Hospital CBC # NPI/Ref # Good Shep O/P Rehab - Bath 5970 Nor Bath Blvd Bath, PA Phone: (610) Fax: (610) Good Shep O/P Rehab - 44 W 21st St, PA Phone: (610) Fax: (610) Good Shep O/P Rehab - Slatebelt 422 Blue Valley Dr Bangor, PA Phone: (610) Fax: (610) Good Shep O/P Therapy 1050 Main St Hellertown, PA Phone: (610) Fax: (610) Good Shep O/P Therapy 602 E 21st St, PA Phone: (610) Fax: (610) Good Shep Rehab - Pediatric Unit 2855 Schoenersville Rd Phone: (610) Fax: (610) Good Shepherd PT 3201 Highfield Dr Ste F Bethlehem, PA Phone: (610) Fax: (610) Northumberland Geisinger HEALTHSOUTH Rehabilitation Hospital CBC # NPI/Ref # Geis HEALTHSOUTH Rehab Ctr of Kulpmont 3 Vermont Dr Kulpmont, PA Phone: (570) Fax: (570) Geis HEALTHSOUTH Rehab Ctr of Milton 155 Arch St Milton, PA Phone: (570) Fax: (570) Snyder Geisinger HEALTHSOUTH Rehabilitation Hospital CBC # NPI/Ref # Geis HEALTHSOUTH Rehab Ctr Selinsgrove 620 University Ave Selinsgrove, PA Phone: (570) Fax: (570) HEALTHSOUTH Rehabilitation Hospital of CBC # NPI/Ref # Normandie Dr, PA Phone: (717) Fax: (717) HEALTHSOUTH Rehab Ctr - Industrial Hwy 2127 Industrial Hwy, PA Phone: (717) Fax: (717) HEALTHSOUTH Rehab Ctr - Red Lion 679 Lombard Rd Red Lion, PA Phone: (717) Fax: (717) Rehabilitation Unit HEALTHSOUTH Reading Rehabilitation Hospital CBC # 39T302 NPI/Ref # Brain Injury Unit 1623 Morgantown Rd Reading, PA Phone: (610) Reading Hospital and Medical Rehabilitation CBC # 39T044 NPI/Ref # Papermill Rd Phone: (484) Fax: (484) HOSPITALS Handicap Accessible Page 333

6 Rehabilitation Unit Centre HEALTHSOUTH Nittany Valley Rehab Brain Treatment CBC # 39T339 NPI/Ref # W College Ave Pleasant Gap, PA Phone: (814) Fax: (814) Columbia Geisinger HEALTHSOUTH Rehabilitation Hospital CBC # 39T347 NPI/Ref # W Front St Berwick, PA Phone: (570) Fax: (570) Carlisle Regional Medical Rehabilitation CBC # 39T058 NPI/Ref # Village Dr Ste 4 Carlisle, PA Phone: (717) Fax: (717) HEALTHSOUTH Rehabilitation of Mech Brain Treatment CBC # 39T310 NPI/Ref # Blvd Mechanicsburg, PA Phone: (717) Fax: (717) Chambersburg Hospital Rehabilitation Unit CBC # 39T151 NPI/Ref # N 7th St Phone: (717) Fax: (717) Regional Medical Rehabilitation CBC # 39T061 NPI/Ref # College Ave, PA Phone: (717) Fax: (717) Good Samaritan Hospital Rehabilitation Unit CBC # 39T066 NPI/Ref # th & Willow Sts, PA Phone: (717) Fax: (717) Good Shepherd Rehabilitation Head/Spinal Rehab CBC # 39T335 NPI/Ref # S 5th St Phone: (610) Fax: (610) Easton Hospital Rehabilitation Unit CBC # 39T162 NPI/Ref # S 21st St Easton, PA Phone: (610) Fax: (610) St Lukes Hospital Rehabilitation Unit CBC # 39T049 NPI/Ref # Ostrum St Bethlehem, PA Phone: (610) Fax: (610) Schuylkill Schuylkill Medical Ctr-E Norwegian St-Rehab Unit CBC # 39T031 NPI/Ref # E Norwegian St Pottsville, PA Phone: (570) Fax: (570) Union Evangelical Counity Hospital Acute Rehab Unit CBC # 39T013 NPI/Ref # Hospital Dr Lewisburg, PA Phone: (570) Fax: (570) HEALTHSOUTH Rehabilitation Hospital of Brain CBC # 39T337 NPI/Ref # Normandie Dr, PA Phone: (717) Fax: (717) HOSPITALS Handicap Accessible Page 334

7 23-Hour Psych Observation 23-Hour Psych Observation Regional Medical CBC # NPI/Ref # College Ave, PA Phone: (717) Fax: (717) Bridge Appointment Program - Outpatient Haven Behavioral Hospital of Eastern PA CBC # NPI/Ref # N 6th St Reading, PA Phone: (610) Fax: (610) Reading Hospital and Medical CBC # NPI/Ref # th Ave & Spruce St Reading, PA Phone: (484) Fax: (484) Crisis Stabilization - Outpatient Holy Spirit Hospital CBC # NPI/Ref # N 21st St Phone: (717) Fax: (717) Fulton TrueNorth Wellness CBC # NPI/Ref # Peach Orchard Rd Mc Connellsburg, PA Phone: (717) Philhaven Hospital CBC # NPI/Ref # Butler Rd Mount Gretna, PA Phone: (717) Fax: (717) County Mental Health CBC # NPI/Ref # S 7th St Allentown, PA Phone: (610) Fax: (610) TrueNorth Wellness CBC # NPI/Ref # Frederick St Hanover, PA Phone: (717) Fax: (717) Electro Convulsive Therapy - Inpatient Reading Hospital and Medical CBC # NPI/Ref # th Ave & Spruce St Reading, PA Phone: (484) Fax: (484) Holy Spirit Hospital CBC # NPI/Ref # N 21st St Phone: (717) Fax: (717) Pennsylvania Psychiatric Institute CBC # NPI/Ref # N 3rd St Phone: (717) Fax: (717) Sacred Heart Hospital CBC # NPI/Ref # W Chew St Allentown, PA Phone: (610) Fax: (610) Valley Hospital - Muhlenberg CBC # NPI/Ref # Behavioral Hlth Science Ctr 2545 Schoenersville Rd Phone: (484) Fax: (484) Electro Convulsive Therapy - Outpatient Reading Hospital and Medical CBC # NPI/Ref # th Ave & Spruce St Reading, PA Phone: (484) Fax: (484) Holy Spirit Hospital CBC # NPI/Ref # N 21st St Phone: (717) Fax: (717) Pennsylvania Psychiatric Institute CBC # NPI/Ref # N 3rd St Phone: (717) Fax: (717) Sacred Heart Hospital CBC # NPI/Ref # W Chew St Allentown, PA Phone: (610) Fax: (610) Valley Hospital - Muhlenberg CBC # NPI/Ref # Behavioral Hlth Science Ctr 2545 Schoenersville Rd Phone: (484) Fax: (484) New Directions Treatment CBC # NPI/Ref # N 6th Ave West Reading, PA Phone: (610) Fax: (610) Methadone Maintenance - Outpatient Habit O/P Allentown CBC # NPI/Ref # S Cedarbrook Rd Phone: (610) Fax: (610) New Directions Treatment CBC # NPI/Ref # Brodhead Rd Bethlehem, PA Phone: (610) Fax: (610) Mobile Outreach Crisis - Outpatient Holy Spirit Hospital CBC # NPI/Ref # N 21st St Phone: (717) Fax: (717) Fulton TrueNorth Wellness CBC # NPI/Ref # Peach Orchard Rd Mc Connellsburg, PA Phone: (717) Philhaven Hospital CBC # NPI/Ref # Butler Rd Mount Gretna, PA Phone: (717) Fax: (717) County Mental Health CBC # NPI/Ref # S 7th St Allentown, PA Phone: (610) Fax: (610) TrueNorth Wellness CBC # NPI/Ref # Frederick St Hanover, PA Phone: (717) Fax: (717) Partial Psych Facility - Intensive Outpatient Counseling CBC # NPI/Ref # Penn St Reading, PA Phone: (610) Fax: (610) Haven Behavioral Hospital of Eastern PA CBC # NPI/Ref # N 6th St Reading, PA Phone: (610) Fax: (610) Holy Spirit Hospital CBC # NPI/Ref # N 21st St Phone: (717) Fax: (717) Pennsylvania Psychiatric Institute CBC # NPI/Ref # Division St Phone: (717) Fax: (717) Philhaven Hospital CBC # NPI/Ref # Herr St Harrisburg, PA Phone: (800) Philhaven Hospital CBC # NPI/Ref # Children & Adolescent O/P Hospitalization 780 Eden Rd, PA Phone: (717) Philhaven Hospital CBC # NPI/Ref # Butler Rd Mount Gretna, PA Phone: (717) Fax: (717) St Lukes Hospital CBC # NPI/Ref # Innovations Psychiatric Partial Hospitalization 1107 Eaton Ave Bethlehem, PA Phone: (484) Philhaven Hospital CBC # NPI/Ref # Children & Adult Day Program 1245 W Princess St Ste A, PA Phone: (717) Fax: (717) WellSpan Behavioral Health CBC # NPI/Ref # Edgar St, PA Phone: (717) Fax: (717) Partial Psych Facility - Outpatient Haven Behavioral Hospital of Eastern PA CBC # NPI/Ref # N 6th St Reading, PA Phone: (610) Fax: (610) Reading Hospital and Medical CBC # NPI/Ref # th Ave & Spruce St Reading, PA Phone: (484) Fax: (484) Centre Meadows Psychiatric CBC # NPI/Ref # The Meadows Dr Centre Hall, PA Phone: (814) Fax: (814) Holy Spirit Hospital CBC # NPI/Ref # N 21st St Phone: (717) Fax: (717) New Insights CBC # NPI/Ref # State St Lemoyne, PA Phone: (717) Fax: (717) Pennsylvania Psychiatric Institute CBC # NPI/Ref # Division St Phone: (717) Fax: (717) BEHAVIORAL HEALTH FACILITIES Handicap Accessible Page 335

8 Partial Psych Facility - Outpatient BEHAVIORAL HEALTH FACILITIES Pennsylvania Psychiatric Institute CBC # NPI/Ref # Northeast Dr Hershey, PA Phone: (717) Fax: (717) Philhaven Hospital CBC # NPI/Ref # Herr St Harrisburg, PA Phone: (800) Regional Medical CBC # NPI/Ref # College Ave, PA Phone: (717) Fax: (717) Philhaven Hospital CBC # NPI/Ref # Children & Adolescent O/P Hospitalization 780 Eden Rd, PA Phone: (717) White Deer Run CBC # NPI/Ref # N West End Ave, PA Phone: (717) Fax: (717) Philhaven Hospital CBC # NPI/Ref # Butler Rd Mount Gretna, PA Phone: (717) Fax: (717) Counseling on Alcohol and Drug Abuse CBC # NPI/Ref # W Linden St Ste 202 Allentown, PA Phone: (610) Fax: (610) Valley Hospital CBC # NPI/Ref # Transitions - Adolescent 1255 S Cedar Crest Blvd Ste 1500 Phone: (610) Fax: (610) Valley Hospital CBC # NPI/Ref # Transitions - Adult 1259 S Cedar Crest Blvd Ste 205 Phone: (610) Fax: (610) St Lukes Hospital CBC # NPI/Ref # Innovations Psychiatric Partial Hospitalization 1107 Eaton Ave Bethlehem, PA Phone: (484) Mifflin Pyramid Healthcare CBC # NPI/Ref # W Main St Belleville, PA Phone: (717) Fax: (717) Valley Hospital - Muhlenberg CBC # NPI/Ref # Behavioral Hlth Science Ctr 2545 Schoenersville Rd Phone: (484) Fax: (484) St Lukes Hospital CBC # NPI/Ref # Ostrum St Bethlehem, PA Phone: (484) Fax: (484) Northumberland Sunbury Counity Hospital CBC # NPI/Ref # N 11th St Sunbury, PA Phone: (570) Philhaven Hospital CBC # NPI/Ref # Children & Adult Day Program 1245 W Princess St Ste A, PA Phone: (717) Fax: (717) TrueNorth Wellness CBC # NPI/Ref # Frederick St Hanover, PA Phone: (717) Fax: (717) Psychiatric - Outpatient Catholic Charities Diocese of Allentown CBC # NPI/Ref # Washington St Reading, PA Phone: (610) Fax: (610) New Directions Treatment CBC # NPI/Ref # N 6th Ave West Reading, PA Phone: (610) Fax: (610) Roxbury Treatment CBC # NPI/Ref # E Louther St Ste 213 Carlisle, PA Phone: (717) Fax: (717) Gaudenzia Outpatient CBC # NPI/Ref # N 2nd St Harrisburg, PA Phone: (717) Fax: (717) Pennsylvania Psychiatric Institute CBC # NPI/Ref # N 3rd St Phone: (717) Fax: (717) Pennsylvania Psychiatric Institute CBC # NPI/Ref # Division St Phone: (717) Fax: (717) Pennsylvania Psychiatric Institute CBC # NPI/Ref # Northeast Dr Hershey, PA Phone: (717) Fax: (717) Roxbury Treatment CBC # NPI/Ref # Penncraft Ave Ste 312 Phone: (717) Fax: (717) Nuestra Clinica of Saca CBC # NPI/Ref # Pershing Ave, PA Phone: (717) Fax: (717) Philhaven for Autism O/P CBC # NPI/Ref # Rohrerstown Rd, PA Phone: (717) Fax: (717) Philhaven Hospital CBC # NPI/Ref # N Reading Rd Ephrata, PA Phone: (717) Fax: (717) Philhaven Hospital CBC # NPI/Ref # Cloverleaf Rd Elizabethtown, PA Phone: (717) Fax: (717) Philhaven Hospital CBC # NPI/Ref # Rohrerstown Rd, PA Phone: (717) White Deer Run CBC # NPI/Ref # N West End Ave, PA Phone: (717) Fax: (717) Philhaven Hospital CBC # NPI/Ref # Hathaway Park, PA Phone: (717) Fax: (717) Philhaven Hospital CBC # NPI/Ref # Butler Rd Mount Gretna, PA Phone: (717) Fax: (717) Catholic Charities Diocese of Allentown CBC # NPI/Ref # Union Blvd Allentown, PA Phone: (610) Fax: (610) Hao Counseling CBC # NPI/Ref # W Walnut St Ste 5 Allentown, PA Phone: (610) Fax: (610) Holcomb Behavioral Health System CBC # NPI/Ref # N Cedar Crest Blvd Ste 105 Phone: (610) Fax: (610) Valley Hospital CBC # NPI/Ref # th & Chew Sts 3rd Fl Allentown, PA Phone: (610) Fax: (610) Pinebrook Family CBC # NPI/Ref # N Fulton St Allentown, PA Phone: (610) Fax: (610) Pyramid Healthcare CBC # NPI/Ref # N Cedar Crest Blvd Ste 602 Phone: (610) Fax: (610) Step By Step CBC # NPI/Ref # W Linden St LL Allentown, PA Phone: (610) Mifflin Pyramid Healthcare CBC # NPI/Ref # W Main St Belleville, PA Phone: (717) Fax: (717) Holcomb Behavioral Health System CBC # NPI/Ref # St Easton, PA Phone: (610) Fax: (610) Valley Drug Abuse CBC # NPI/Ref # S 3rd St Ste 4 Easton, PA Phone: (610) Fax: (610) Valley Drug Abuse CBC # NPI/Ref # E Broad St Ste 20 Bethlehem, PA Phone: (610) Fax: (610) Valley Hospital CBC # NPI/Ref # Schoenersville Rd Phone: (610) Fax: (610) Methodist for Child and Families CBC # NPI/Ref # Market St Bangor, PA Phone: (610) Fax: (610) Methodist for Child and Families CBC # NPI/Ref # St Easton, PA Phone: (610) Fax: (610) New Directions Treatment CBC # NPI/Ref # Brodhead Rd Bethlehem, PA Phone: (610) Fax: (610) Pinebrook Family CBC # NPI/Ref # S Broadway Wind Gap, PA Phone: (610) Fax: (610) Pinebrook for Children and Youth CBC # NPI/Ref # St Ste 201 Easton, PA Phone: (610) Fax: (610) Step By Step CBC # NPI/Ref # W Union Blvd Bethlehem, PA Phone: (610) Fax: (610) Schuylkill Catholic Charities Diocese of Allentown CBC # NPI/Ref # Westwood Ctr Pottsville, PA Phone: (570) Fax: (570) Handicap Accessible Page 336

9 Substance Abuse Detox - Intensive Outpatient Psychiatric Hospital Haven Behavioral Hospital of Eastern PA CBC # NPI/Ref # N 6th St Reading, PA Phone: (610) Fax: (610) Reading Hospital and Medical CBC # NPI/Ref # th Ave & Spruce St Reading, PA Phone: (484) Fax: (484) Centre Meadows Psychiatric CBC # NPI/Ref # The Meadows Dr Centre Hall, PA Phone: (814) Fax: (814) Holy Spirit Hospital CBC # NPI/Ref # N 21st St Phone: (717) Fax: (717) Pennsylvania Psychiatric Institute CBC # NPI/Ref # N 3rd St Phone: (717) Fax: (717) Roxbury Treatment CBC # NPI/Ref # Roxbury Rd Shippensburg, PA Phone: (717) Fax: (717) Regional Medical CBC # NPI/Ref # College Ave, PA Phone: (717) Fax: (717) Philhaven Hospital CBC # NPI/Ref # Butler Rd Mount Gretna, PA Phone: (717) Fax: (717) Sacred Heart Hospital CBC # NPI/Ref # W Chew St Allentown, PA Phone: (610) Fax: (610) Valley Hospital - Muhlenberg CBC # NPI/Ref # Behavioral Hlth Science Ctr 2545 Schoenersville Rd Phone: (484) Fax: (484) St Lukes Hospital CBC # NPI/Ref # Ostrum St Bethlehem, PA Phone: (484) Fax: (484) Northumberland Sunbury Counity Hospital CBC # NPI/Ref # N 11th St Sunbury, PA Phone: (570) Substance Abuse Detox - Inpatient White Deer Run CBC # NPI/Ref # Leaser Rd Kempton, PA Phone: (610) Fax: (610) Roxbury Treatment CBC # NPI/Ref # Roxbury Rd Shippensburg, PA Phone: (717) Gaudenzia CBC # NPI/Ref # N Front St Phone: (717) White Deer Run CBC # NPI/Ref # N West End Ave, PA Phone: (717) Fax: (717) White Deer Run CBC # NPI/Ref # Riverside Dr Bethlehem, PA Phone: (855) Fax: (610) Schuylkill Conewago Place CBC # NPI/Ref # S Centre St Pottsville, PA Phone: (570) Fax: (570) Union White Deer Run CBC # NPI/Ref # White Deer Run Allenwood, PA Phone: (800) Fax: (570) Substance Abuse Detox - Intensive Outpatient Adams Pennsylvania Counseling CBC # NPI/Ref # St Gettysburg, PA Phone: (717) Fax: (717) Counseling CBC # NPI/Ref # Penn St Reading, PA Phone: (610) Fax: (610) New Directions Treatment CBC # NPI/Ref # N 6th Ave West Reading, PA Phone: (610) Fax: (610) Pennsylvania Counseling CBC # NPI/Ref # Penn St Reading, PA Phone: (610) Fax: (610) Pennsylvania Counseling CBC # NPI/Ref # S 5th St Reading, PA Phone: (610) Fax: (610) Gaudenzia Outpatient CBC # NPI/Ref # Delbrook Rd Mechanicsburg, PA Phone: (717) Fax: (717) Holy Spirit Hospital CBC # NPI/Ref # N 21st St Phone: (717) Fax: (717) New Insights CBC # NPI/Ref # State St Lemoyne, PA Phone: (717) Fax: (717) Roxbury Treatment CBC # NPI/Ref # Roxbury Rd Shippensburg, PA Phone: (717) Gaudenzia Outpatient CBC # NPI/Ref # N 2nd St Harrisburg, PA Phone: (717) Fax: (717) Mazzitti and Sullivan CBC # NPI/Ref # N Front St Phone: (717) Fax: (717) Pennsylvania Counseling CBC # NPI/Ref # Locust Ln Phone: (717) Fax: (717) White Deer Run CBC # NPI/Ref # N Front St Stes Harrisburg, PA Phone: (717) Fax: (717) Pennsylvania Counseling CBC # NPI/Ref # S Main St Phone: (717) Fax: (717) Freedom CBC # NPI/Ref # N Lime St, PA Phone: (717) Fax: (717) Mazzitti and Sullivan CBC # NPI/Ref # W Liberty St Ste 358, PA Phone: (717) Fax: (717) Nuestra Clinica of Saca CBC # NPI/Ref # Pershing Ave, PA Phone: (717) Fax: (717) Pennsylvania Counseling CBC # NPI/Ref # Pearl St, PA Phone: (717) Fax: (717) Rehab After Work CBC # NPI/Ref # Oregon Pike Ste 205B, PA Phone: (610) Fax: (610) White Deer Run CBC # NPI/Ref # N West End Ave, PA Phone: (717) Fax: (717) Pennsylvania Counseling CBC # NPI/Ref # St, PA Phone: (717) Fax: (717) Counseling on Alcohol and Drug Abuse CBC # NPI/Ref # W Linden St Ste 202 Allentown, PA Phone: (610) Fax: (610) Livengrin Foundation CBC # NPI/Ref # Hanover Office Plz 961 Marcon Blvd Ste 304 Allentown, PA Phone: (610) Fax: (610) Malvern Institute CBC # NPI/Ref # Marcon Blvd Allentown, PA Phone: (610) Fax: (610) Mid Atlantic Rehab CBC # NPI/Ref # Delaware Ave Bethlehem, PA Phone: (610) Fax: (610) Pyramid Healthcare CBC # NPI/Ref # N Cedar Crest Blvd Ste 602 Phone: (610) Fax: (610) Raft Treatment LLC CBC # NPI/Ref # Broad St Ste 101 Eaus, PA Phone: (610) Fax: (610) White Deer Run CBC # NPI/Ref # S Cedar Crest Blvd Ste 308 Phone: (610) Fax: (610) New Directions Treatment CBC # NPI/Ref # Brodhead Rd Bethlehem, PA Phone: (610) Fax: (610) Northeast Treatment s CBC # NPI/Ref # E Broad St Bethlehem, PA Phone: (610) Fax: (610) BEHAVIORAL HEALTH FACILITIES Handicap Accessible Page 337

10 Substance Abuse Detox - Intensive Outpatient BEHAVIORAL HEALTH FACILITIES Northumberland Gaudenzia Outpatient CBC # NPI/Ref # N 4th St Sunbury, PA Phone: (570) Fax: (570) Union White Deer Run CBC # NPI/Ref # Farley Cir Ste 303 Lewisburg, PA Phone: (570) Fax: (570) New Insights CBC # NPI/Ref # Carlisle Ave, PA Phone: (717) Fax: (717) Pennsylvania Counseling CBC # NPI/Ref # N George St, PA Phone: (717) Fax: (717) Rehab After Work CBC # NPI/Ref # Wyntre Brooke Dr LL, PA Phone: (610) Fax: (610) WellSpan Behavioral Health CBC # NPI/Ref # Edgar St, PA Phone: (717) Fax: (717) Substance Abuse Detox - Outpatient Counseling CBC # NPI/Ref # Penn St Reading, PA Phone: (610) Fax: (610) WellSpan Behavioral Health CBC # NPI/Ref # Edgar St, PA Phone: (717) Fax: (717) Substance Abuse Detox - Partial Hospitalization New Insights CBC # NPI/Ref # State St Lemoyne, PA Phone: (717) Fax: (717) Freedom CBC # NPI/Ref # N Lime St, PA Phone: (717) Fax: (717) White Deer Run CBC # NPI/Ref # N West End Ave, PA Phone: (717) Fax: (717) Counseling on Alcohol and Drug Abuse CBC # NPI/Ref # W Linden St Ste 202 Allentown, PA Phone: (610) Fax: (610) Livengrin Foundation CBC # NPI/Ref # Hanover Office Plz 961 Marcon Blvd Ste 304 Allentown, PA Phone: (610) Fax: (610) Pyramid Healthcare CBC # NPI/Ref # N Cedar Crest Blvd Ste 602 Phone: (610) Fax: (610) Mifflin Pyramid Healthcare CBC # NPI/Ref # W Main St Belleville, PA Phone: (717) Fax: (717) New Insights CBC # NPI/Ref # Carlisle Ave, PA Phone: (717) Fax: (717) Substance Abuse Disorder - Inpatient Mifflin Pyramid Healthcare CBC # NPI/Ref # W Main St Belleville, PA Phone: (717) Fax: (717) Substance Abuse Disorder - Outpatient Adams Pennsylvania Counseling CBC # NPI/Ref # St Gettysburg, PA Phone: (717) Fax: (717) Counseling CBC # NPI/Ref # Penn St Reading, PA Phone: (610) Fax: (610) for Mental Health At Reading Hospital CBC # NPI/Ref # Kutztown Boehm Science Kutztown Rd Kutztown, PA Phone: (484) New Directions Treatment CBC # NPI/Ref # N 6th Ave West Reading, PA Phone: (610) Fax: (610) Pennsylvania Counseling CBC # NPI/Ref # Penn St Reading, PA Phone: (610) Fax: (610) Reading Hospital and Medical CBC # NPI/Ref # th Ave & Spruce St Reading, PA Phone: (484) Fax: (484) Reading Hospital and Medical CBC # NPI/Ref # N Furnace St Ste 100 Birdsboro, PA Phone: (610) Fax: (610) Reading Hospital and Medical CBC # NPI/Ref # Buttonwood St Reading, PA Phone: (610) Fax: (484) Gaudenzia Outpatient CBC # NPI/Ref # Delbrook Rd Mechanicsburg, PA Phone: (717) Fax: (717) New Insights CBC # NPI/Ref # State St Lemoyne, PA Phone: (717) Fax: (717) Roxbury Treatment CBC # NPI/Ref # Roxbury Rd Shippensburg, PA Phone: (717) Roxbury Treatment CBC # NPI/Ref # E Louther St Ste 213 Carlisle, PA Phone: (717) Fax: (717) Gaudenzia Outpatient CBC # NPI/Ref # N 2nd St Harrisburg, PA Phone: (717) Fax: (717) Mazzitti and Sullivan CBC # NPI/Ref # E Chocolate Ave Hershey, PA Phone: (717) Mazzitti and Sullivan CBC # NPI/Ref # N Front St Phone: (717) Fax: (717) Pennsylvania Counseling CBC # NPI/Ref # Locust Ln Phone: (717) Fax: (717) White Deer Run CBC # NPI/Ref # N Front St Stes Harrisburg, PA Phone: (717) Fax: (717) Pennsylvania Counseling CBC # NPI/Ref # S Main St Phone: (717) Fax: (717) Roxbury Treatment CBC # NPI/Ref # Penncraft Ave Ste 312 Phone: (717) Fax: (717) Freedom CBC # NPI/Ref # N Lime St, PA Phone: (717) Fax: (717) Mazzitti and Sullivan CBC # NPI/Ref # W Liberty St Ste 358, PA Phone: (717) Fax: (717) Nuestra Clinica of Saca CBC # NPI/Ref # Pershing Ave, PA Phone: (717) Fax: (717) Nuestra Clinica of Saca CBC # NPI/Ref # E New St, PA Phone: (717) Fax: (717) Pennsylvania Counseling CBC # NPI/Ref # Pearl St, PA Phone: (717) Fax: (717) Rehab After Work CBC # NPI/Ref # Oregon Pike Ste 205B, PA Phone: (610) Fax: (610) White Deer Run CBC # NPI/Ref # N West End Ave, PA Phone: (717) Fax: (717) Pennsylvania Counseling CBC # NPI/Ref # St, PA Phone: (717) Fax: (717) White Deer Run CBC # NPI/Ref # Chestnut St, PA Phone: (717) Fax: (717) Counseling on Alcohol and Drug Abuse CBC # NPI/Ref # W Linden St Ste 202 Allentown, PA Phone: (610) Fax: (610) Habit O/P Allentown CBC # NPI/Ref # S Cedarbrook Rd Phone: (610) Fax: (610) Livengrin Foundation CBC # NPI/Ref # Hanover Office Plz 961 Marcon Blvd Ste 304 Allentown, PA Phone: (610) Fax: (610) Malvern Institute CBC # NPI/Ref # Marcon Blvd Allentown, PA Phone: (610) Fax: (610) Mid Atlantic Rehab CBC # NPI/Ref # Delaware Ave Bethlehem, PA Phone: (610) Fax: (610) Pinebrook Family CBC # NPI/Ref # N Fulton St Allentown, PA Phone: (610) Fax: (610) Handicap Accessible Page 338

11 Telephone Crisis - Outpatient Pyramid Healthcare CBC # NPI/Ref # N Cedar Crest Blvd Ste 602 Phone: (610) Fax: (610) Raft Treatment LLC CBC # NPI/Ref # Broad St Ste 101 Eaus, PA Phone: (610) Fax: (610) Step By Step CBC # NPI/Ref # W Linden St LL Allentown, PA Phone: (610) Treatment Trends CBC # NPI/Ref # W Walnut St Allentown, PA Phone: (610) Fax: (610) White Deer Run CBC # NPI/Ref # S Cedar Crest Blvd Ste 308 Phone: (610) Fax: (610) Mifflin Pyramid Healthcare CBC # NPI/Ref # W Main St Belleville, PA Phone: (717) Fax: (717) Net Treatment CBC # NPI/Ref # S 3rd St Ste 508 Easton, PA Phone: (610) Fax: (610) New Directions Treatment CBC # NPI/Ref # Brodhead Rd Bethlehem, PA Phone: (610) Fax: (610) Northeast Treatment s CBC # NPI/Ref # E Broad St Bethlehem, PA Phone: (610) Fax: (610) Pinebrook Family CBC # NPI/Ref # S Broadway Wind Gap, PA Phone: (610) Fax: (610) Pinebrook for Children and Youth CBC # NPI/Ref # St Ste 201 Easton, PA Phone: (610) Fax: (610) Step By Step CBC # NPI/Ref # W Union Blvd Bethlehem, PA Phone: (610) Fax: (610) Northumberland Gaudenzia Outpatient CBC # NPI/Ref # N 4th St Sunbury, PA Phone: (570) Fax: (570) Schuylkill Conewago Place CBC # NPI/Ref # S Centre St Pottsville, PA Phone: (570) Fax: (570) Union White Deer Run CBC # NPI/Ref # Farley Cir Ste 303 Lewisburg, PA Phone: (570) Fax: (570) New Insights CBC # NPI/Ref # Carlisle Ave, PA Phone: (717) Fax: (717) Pennsylvania Counseling CBC # NPI/Ref # N George St, PA Phone: (717) Fax: (717) Rehab After Work CBC # NPI/Ref # Wyntre Brooke Dr LL, PA Phone: (610) Fax: (610) Substance Abuse Rehab - Inpatient Reading Hospital and Medical CBC # NPI/Ref # Buttonwood St Reading, PA Phone: (610) Fax: (484) White Deer Run CBC # NPI/Ref # Leaser Rd Kempton, PA Phone: (610) Fax: (610) Holy Spirit Hospital CBC # NPI/Ref # N 21st St Phone: (717) Fax: (717) Roxbury Treatment CBC # NPI/Ref # Roxbury Rd Shippensburg, PA Phone: (717) Conewago Place CBC # NPI/Ref # Nyes Rd Huelstown, PA Phone: (717) Fax: (717) Gaudenzia Coonground CBC # NPI/Ref # N Front St Phone: (717) Fax: (717) Gaudenzia Concept 90 CBC # NPI/Ref # E Azalea Dr PO Box Phone: (717) Fax: (717) Gaudenzia CBC # NPI/Ref # N Front St Phone: (717) Gaudenzia Outpatient CBC # NPI/Ref # Chambers Hill Rd Harrisburg, PA Phone: (717) Fax: (717) Drug and Alcohol Rehab CBC # NPI/Ref # Prospect Rd Columbia, PA Phone: (717) Fax: (717) Gaudenzia Vantage House CBC # NPI/Ref # E King St, PA Phone: (717) Fax: (717) Manos House CBC # NPI/Ref # Prospect Rd Columbia, PA Phone: (717) Fax: (717) Nuestra Clinica of Saca CBC # NPI/Ref # E New St, PA Phone: (717) Fax: (717) White Deer Run CBC # NPI/Ref # N West End Ave, PA Phone: (717) Fax: (717) Treatment Trends CBC # NPI/Ref # S 6th St Allentown, PA Phone: (610) Fax: (610) Mifflin Pyramid Healthcare CBC # NPI/Ref # W Main St Belleville, PA Phone: (717) Fax: (717) Schuylkill Conewago Place CBC # NPI/Ref # S Centre St Pottsville, PA Phone: (570) Fax: (570) Gaudenzia Fountain Springs CBC # NPI/Ref # Broad St Ashland, PA Phone: (570) Fax: (570) Snyder Firetree Ltd CBC # NPI/Ref # Rte 522 Beavertown, PA Phone: (570) Fax: (570) Union White Deer Run CBC # NPI/Ref # White Deer Run Allenwood, PA Phone: (800) Fax: (570) White Deer Run CBC # NPI/Ref # Davies Dr, PA Phone: (717) Fax: (717) Telephone Crisis - Outpatient Holy Spirit Hospital CBC # NPI/Ref # N 21st St Phone: (717) Fax: (717) Fulton TrueNorth Wellness CBC # NPI/Ref # Peach Orchard Rd Mc Connellsburg, PA Phone: (717) Philhaven Hospital CBC # NPI/Ref # Butler Rd Mount Gretna, PA Phone: (717) Fax: (717) County Mental Health CBC # NPI/Ref # S 7th St Allentown, PA Phone: (610) Fax: (610) TrueNorth Wellness CBC # NPI/Ref # Frederick St Hanover, PA Phone: (717) Fax: (717) BEHAVIORAL HEALTH FACILITIES Handicap Accessible Page 339

12 The following section lists network skilled nursing facilities. Preauthorization Requirements SKILLED NURSING FACILITIES Some services must be preauthorized. Preauthorization for SecureChoice SM Members is an approval process used to determine member eligibility, benefit coverage and medical necessity of proposed services at the time of the request. You may ask your provider if the service requires preauthorization. Network providers are responsible for knowing which services require preauthorization and for obtaining preauthorization from Keystone Health Plan Central or its designated representative before providing the service. Important Notes This directory is accurate only as of the date the information was generated for this printing. To check the most current participation status of any particular provider, visit our website at capbluecross.com/healthypa or call the toll-free number on your ID card. You may also contact our Customer Service Department for SecureChoice SM Members at (TTY 711), Monday through Friday, 8:00 AM to 6:00 PM, or contact the provider directly to verify their participation in SecureChoice SM. If you have questions about your benefits or any other aspect of your health care coverage, please call the toll-free number on your ID card or contact our Customer Service Department for SecureChoice SM Members at (TTY 711), Monday through Friday, 8:00 AM to 6:00 PM. After normal business hours, you may leave a voice mail message and a Customer Service Representative will return your call during the next business day. Always present your Member identification card each time you seek medical services. For detailed information concerning your benefits, please refer to your Member handbook. Page 341

13 Adams Adams Cross Keys Village CBC # NPI/Ref # Carlisle Pike New Oxford, PA Phone: (717) Fax: (717) Gettysburg Lutheran Home CBC # NPI/Ref # Old Harrisburg Rd Gettysburg, PA Phone: (717) Fax: (717) Golden Living - Gettysburg CBC # NPI/Ref # Chambersburg Rd Gettysburg, PA Phone: (717) Fax: (717) Transitions Healthcare Gettysburg LLC CBC # NPI/Ref # Biglerville Rd Gettysburg, PA Phone: (717) Fax: (717) Village of Laurel Run (The) CBC # NPI/Ref # Chambersburg Rd Fayetteville, PA Phone: (717) Fax: (717) Heim CBC # NPI/Ref # Rd Leesport, PA Phone: (610) Fax: (610) hire CBC # NPI/Ref # Perkiomen Ave Reading, PA Phone: (610) Fax: (610) Golden Living - Reading CBC # NPI/Ref # Fairlane Rd Reading, PA Phone: (610) Fax: (610) Highlands at Wyomissing CBC # NPI/Ref # Cambridge Ave Phone: (610) Fax: (610) Kutztown Manor CBC # NPI/Ref # Trexler Ave Kutztown, PA Phone: (610) Fax: (610) Laurel - PA CBC # NPI/Ref # Holly Rd Hamburg, PA Phone: (610) Fax: (610) Lutheran Home at Topton CBC # NPI/Ref # S Home Ave Topton, PA Phone: (610) Fax: (610) ManorCare Health - Laureldale #562 CBC # NPI/Ref # Elizabeth Ave Laureldale, PA Phone: (610) Fax: (610) ManorCare Health - Sinking Springs #576 CBC # NPI/Ref # Windmill Rd Sinking Spring, PA Phone: (610) Fax: (610) ManorCare Health - W Reading North #568 CBC # NPI/Ref # Buttonwood St West Reading, PA Phone: (610) Fax: (610) Mifflin CBC # NPI/Ref # E Philadelphia Ave Shillington, PA Phone: (610) Fax: (610) Phoebe Health Care CBC # NPI/Ref # Heidelberg Dr Wernersville, PA Phone: (610) Fax: (610) Spruce Manor Nursing and Rehabilitation CBC # NPI/Ref # S 4th Ave West Reading, PA Phone: (610) Fax: (610) Transitional Care at Reading Hospital CBC # NPI/Ref # Papermill Rd Phone: (484) Fax: (484) Wyomissing Health and Rehabilitation CBC # NPI/Ref # E Wyomissing Blvd Reading, PA Phone: (610) Fax: (610) Centre Centre Crest CBC # NPI/Ref # E Howard St Bellefonte, PA Phone: (814) Fax: (814) Hearthside A Nursing and Rehabilitation The CBC # NPI/Ref # Waupelani Dr State College, PA Phone: (814) Fax: (814) Juniper Village at Brookline CBC # NPI/Ref # Cliffside Dr State College, PA Phone: (814) Fax: (814) The Village at Penn State CBC # NPI/Ref # Lions Hill Rd State College, PA Phone: (814) Fax: (814) Columbia Balanced Care at Bloomsburg CBC # NPI/Ref # Ridge Rd Bloomsburg, PA Phone: (570) Fax: (570) Berwick Retirement Village Nursing Home CBC # NPI/Ref # E 16th St Berwick, PA Phone: (570) Millville Health CBC # NPI/Ref # Haven Ln Millville, PA Phone: (570) Fax: (570) Orangeville Nursing and Rehabilitation CBC # NPI/Ref # Berwick Rd Orangeville, PA Phone: (570) Fax: (570) Bethany Village CBC # NPI/Ref # Wesley Dr Mechanicsburg, PA Phone: (717) Fax: (717) Chapel Pointe at Carlisle CBC # NPI/Ref # S Hanover St Carlisle, PA Phone: (717) Fax: (717) Church of God Home CBC # NPI/Ref # N Hanover St Carlisle, PA Phone: (717) Claremont Nursing and Rehab Ctr of Cty CBC # NPI/Ref # Claremont Rd Carlisle, PA Phone: (717) Fax: (717) Crossings CBC # NPI/Ref # Longsdorf Way Carlisle, PA Phone: (717) Fax: (717) Forest Park Health CBC # NPI/Ref # Walnut Bottom Rd Carlisle, PA Phone: (717) Fax: (717) Fox Subacute at Mechanicsburg LLC CBC # NPI/Ref # S Filbert St Mechanicsburg, PA Phone: (717) Fax: (717) Golden Living - Camp Hill CBC # NPI/Ref # Erford Rd Phone: (717) Fax: (717) Golden Living - West Shore CBC # NPI/Ref # Poplar Church Rd Phone: (717) Fax: (717) ManorCare Health - Camp Hill #583 CBC # NPI/Ref # Market St Phone: (717) Fax: (717) ManorCare Health - Carlisle #372 CBC # NPI/Ref # Walnut Bottom Rd Carlisle, PA Phone: (717) Fax: (717) Messiah Village CBC # NPI/Ref # Mt Allen Dr Mechanicsburg, PA Phone: (717) Fax: (717) Sarah Todd Memorial Home CBC # NPI/Ref # W South St Carlisle, PA Phone: (717) Fax: (717) Shippensburg Health Care CBC # NPI/Ref # Walnut Bottom Rd Shippensburg, PA Phone: (717) Fax: (717) Swaim Health CBC # NPI/Ref # Big Spring Rd Newville, PA Phone: (717) Fax: (717) Thornwald Home CBC # NPI/Ref # Walnut Bottom Rd Carlisle, PA Phone: (717) Fax: (717) Vibra Rehabilitation CBC # NPI/Ref # Shepherdstown Rd Mechanicsburg, PA Phone: (717) Fax: (717) Colonial Park Care LLC CBC # NPI/Ref # King Russ Rd Phone: (717) Fax: (717) Courtyard Gardens CBC # NPI/Ref # W Harrisburg Pike Middletown, PA Phone: (717) Fax: (717) Frey Village CBC # NPI/Ref # N Union St Middletown, PA Phone: (717) Fax: (717) Golden Living - Blue Ridge Mountain CBC # NPI/Ref # N Progress Ave Phone: (717) Fax: (717) Homeland CBC # NPI/Ref # N 5th St Harrisburg, PA Phone: (717) Fax: (717) Jewish Home of Greater Harrisburg CBC # NPI/Ref # Linglestown Rd Harrisburg, PA Phone: (717) Fax: (717) Kepler for Nursing and Rehabilitation CBC # NPI/Ref # S Market St Elizabethville, PA Phone: (717) Fax: (717) Manor at Susquehanna Village (The) CBC # NPI/Ref # Medical Rd Millersburg, PA Phone: (717) Fax: (717) Penn State Hershey Rehabilitation - TCU CBC # NPI/Ref # Old Chocolate Ave Huelstown, PA Phone: (717) Fax: (717) Spring Creek Rehabilitation and Health Care CBC # NPI/Ref # S 28th St Harrisburg, PA Phone: (717) Fax: (717) SKILLED NURSING FACILITIES Handicap Accessible Page 343

14 SKILLED NURSING FACILITIES Falling Spring Nursing and Rehabilitation CBC # NPI/Ref # Farm Ln Chambersburg, PA Phone: (717) Fax: (717) ManorCare Health - Chambersburg #556 CBC # NPI/Ref # Stauffer Ave Phone: (717) Fax: (717) Menno Village at Menno Haven CBC # NPI/Ref # Scotland Ave Phone: (717) Fax: (717) Penn Hall at Menno Haven CBC # NPI/Ref # Philadelphia Ave Phone: (717) Fax: (717) Quincy Village CBC # NPI/Ref # Colestock 6596 Orphanage Rd Waynesboro, PA Phone: (717) Fax: (717) Shook Home (The) CBC # NPI/Ref # S 2nd St Phone: (717) Fax: (717) Fulton Fulton County Medical CBC # NPI/Ref # Peach Orchard Rd Mc Connellsburg, PA Phone: (717) Fax: (717) Juniata Brookline at Mifflintown CBC # NPI/Ref # Manor Blvd Mifflintown, PA Phone: (717) Fax: (717) Locust Grove Retirement Village CBC # NPI/Ref # Cottage Rd Mifflin, PA Phone: (717) Fax: (717) Richfield Senior Living and Rehabilitation CBC # NPI/Ref # Main St Richfield, PA Phone: (717) Fax: (717) Audubon Villa Health and Rehabilitation CBC # NPI/Ref # S Broad St Lititz, PA Phone: (717) Fax: (717) Brethren Village CBC # NPI/Ref # Lititz Pike, PA Phone: (717) Fax: (717) Calvary Fellowship Home CBC # NPI/Ref # Elizabeth Dr, PA Phone: (717) Fax: (717) Conestoga View Nursing Home CBC # NPI/Ref # E King St, PA Phone: (717) Fax: (717) Denver Health and Rehabilitation CBC # NPI/Ref # Ave Stevens, PA Phone: (717) Fax: (717) Ephrata Manor CBC # NPI/Ref # Bethany Rd Ephrata, PA Phone: (717) Fax: (717) Fairmount Homes CBC # NPI/Ref # Wheat Ridge Dr Ephrata, PA Phone: (717) Fax: (717) Glen at Willow Valley (The) CBC # NPI/Ref # Willow Valley Sq, PA Phone: (717) Fax: (717) Golden Living - CBC # NPI/Ref # N Duke St, PA Phone: (717) Fax: (717) Hamilton Arms CBC # NPI/Ref # S West End Ave, PA Phone: (717) Fax: (717) Harrison Senior Living of Christiana LLC CBC # NPI/Ref # Newport Ave Christiana, PA Phone: (610) Fax: (610) Homestead Village CBC # NPI/Ref # Village Cir, PA Phone: (717) Fax: (717) Lakeside at Willow Valley CBC # NPI/Ref # Willow Vly Lakes Dr Willow Street, PA Phone: (717) Fax: (717) Lancashire Hall Nursing and Rehabilitation CBC # NPI/Ref # Lititz Pike, PA Phone: (717) Fax: (717) Landis Homes CBC # NPI/Ref # E Oregon Rd Lititz, PA Phone: (717) Fax: (717) Luther Acres Manor CBC # NPI/Ref # St Luke Dr Lititz, PA Phone: (717) Fax: (717) ManorCare Health - Elizabethtown #582 CBC # NPI/Ref # S Market St Elizabethtown, PA Phone: (717) Fax: (717) ManorCare Health - #569 CBC # NPI/Ref # Abbeyville Rd, PA Phone: (717) Fax: (717) Masonic Village at Elizabethtown CBC # NPI/Ref # Masonic Dr Elizabethtown, PA Phone: (717) Fax: (717) Mennonite Home CBC # NPI/Ref # Harrisburg Pike, PA Phone: (717) Fax: (717) Moravian Manor CBC # NPI/Ref # W Lemon St Lititz, PA Phone: (717) Fax: (717) Mt Hope Nazarene Retirement Counity CBC # NPI/Ref # Mt Hope Home Rd Manheim, PA Phone: (717) Fax: (717) Pleasant View Retirement Counity CBC # NPI/Ref # N Penryn Rd Manheim, PA Phone: (717) Fax: (717) Rheems Nursing and Rehabilitation CBC # NPI/Ref # Heisey Ave Elizabethtown, PA Phone: (717) Fax: (717) Susquehanna Valley Nursing and Rehabilitation Ctr CBC # NPI/Ref # Chiques Hill Rd Columbia, PA Phone: (717) Fax: (717) Cornwall Manor CBC # NPI/Ref # Boyd St Cornwall, PA Phone: (717) Fax: (717) Countryside Christian Counity CBC # NPI/Ref # Bellann Ct Annville, PA Phone: (717) Fax: (717) Good Samaritan Hospital Transitional Care Unit CBC # NPI/Ref # th & Willow Sts, PA Phone: (717) Fax: (717) Valley Home (The) CBC # NPI/Ref # E Main St Annville, PA Phone: (717) Fax: (717) ManorCare Health - #561 CBC # NPI/Ref # Tuck St, PA Phone: (717) Fax: (717) Palmyra Health and Rehabilitation CBC # NPI/Ref # N Railroad St Palmyra, PA Phone: (717) Fax: (717) Spang Crest Manor CBC # NPI/Ref # Duke St, PA Phone: (717) Fax: (717) StoneRidge Poplar Run CBC # NPI/Ref # E Lincoln Ave Myerstown, PA Phone: (717) Fax: (717) StoneRidge Towne Centre CBC # NPI/Ref # W Park Ave Myerstown, PA Phone: (717) Twin Oaks Health and Rehabilitation CBC # NPI/Ref # Horseshoe Pike Palmyra, PA Phone: (717) Fax: (717) Cedarbrook County Home CBC # NPI/Ref # S Cedarbrook Rd Phone: (610) Fax: (610) Fellowship Manor CBC # NPI/Ref # Fellowship Dr Whitehall, PA Phone: (610) Fax: (610) Good Shepherd Home at C W Raker CBC # NPI/Ref # St John St Phone: (610) Fax: (610) Holy Family Manor CBC # NPI/Ref # Spring St Bethlehem, PA Phone: (610) Fax: (610) CBC # NPI/Ref # Spring Creek Rd Macungie, PA Phone: (610) Fax: (610) Valley Hospital Transitional Skilled Unit CBC # NPI/Ref # th & Chew Sts Allentown, PA Phone: (610) Fax: (610) Liberty Nursing and Rehabilitation #4068 CBC # NPI/Ref # N 17th St Phone: (610) Fax: (610) Luther Crest Nursing Facility CBC # NPI/Ref # Hausman Rd Phone: (610) Fax: (610) ManorCare Health - Allentown #481 CBC # NPI/Ref # S Cedar Crest Blvd Phone: (610) Fax: (610) Handicap Accessible Page 344

15 Union ManorCare Health - Bethlehem II CBC # NPI/Ref # Westgate Dr Phone: (610) Fax: (610) Mosser Nursing Home CBC # NPI/Ref # Mosser Rd PO Box 133 Trexlertown, PA Phone: (610) Fax: (610) Phoebe Home (The) CBC # NPI/Ref # Turner St Phone: (610) Fax: (610) Sacred Heart Hospital Transitional Care Facility CBC # NPI/Ref # Chew St Allentown, PA Phone: (610) Fax: (610) Valley Manor Nursing and Rehabilitation CBC # NPI/Ref # Rte 309 Coopersburg, PA Phone: (610) Fax: (610) Westminster Village CBC # NPI/Ref # N Wahneta St Allentown, PA Phone: (610) Fax: (610) Mifflin Golden Living - William Penn CBC # NPI/Ref # Suit Dr Lewistown, PA Phone: (717) Fax: (717) Malta Home Retirement Counity CBC # NPI/Ref # Malta Dr Granville, PA Phone: (717) Fax: (717) Ohesson Manor CBC # NPI/Ref # Green Ave Ext Lewistown, PA Phone: (717) Fax: (717) Valley View Haven CBC # NPI/Ref # E Main St Belleville, PA Phone: (717) Montour Grandview Health Homes CBC # NPI/Ref # Woodbine Ln Danville, PA Phone: (570) Fax: (570) Maria Joseph Manor CBC # NPI/Ref # Montour Rd Danville, PA Phone: (570) Fax: (570) Blough Healthcare LLC CBC # NPI/Ref # E Market St Bethlehem, PA Phone: (610) Fax: (610) Cedarbrook County Home CBC # NPI/Ref # Fountain Hill Annex 724 Delaware Ave Bethlehem, PA Phone: (610) Fax: (610) Easton Health and Rehabilitation CBC # NPI/Ref # Washington St Easton, PA Phone: (610) Fax: (610) Gracedale Nursing Home CBC # NPI/Ref # Gracedale Ave Nazareth, PA Phone: (610) Fax: (610) Kirkland Village CBC # NPI/Ref # Kirkland Village Cir Phone: (610) Fax: (610) ManorCare Health - Bethlehem (2021) #555 CBC # NPI/Ref # Westgate Dr Phone: (610) Fax: (610) ManorCare Health - Easton #574 CBC # NPI/Ref # St Easton, PA Phone: (610) Fax: (610) Moravian Hall Square Health and Wellness CBC # NPI/Ref # W North St Nazareth, PA Phone: (610) Fax: (610) Moravian Village of Bethlehem CBC # NPI/Ref # E Broad St Bethlehem, PA Phone: (610) Fax: (610) New Eastwood Healthcare and Rehabilitation CBC # NPI/Ref # Fairview Ave Easton, PA Phone: (610) Fax: (610) Old Orchard Health Care #575 CBC # NPI/Ref # Freemansburg Ave Easton, PA Phone: (610) Fax: (610) Praxis Alzheimers Facility CBC # NPI/Ref # Washington St Easton, PA Phone: (610) Fax: (610) Slate Belt Nursing and Rehabilitation CBC # NPI/Ref # Slate Belt Blvd Bangor, PA Phone: (610) Fax: (610) Weston Rehabilitation and Nursing CBC # NPI/Ref # Leithesville Rd Hellertown, PA Phone: (610) Fax: (610) Northumberland Golden Living - Mansion CBC # NPI/Ref # Market St Sunbury, PA Phone: (570) Fax: (570) ManorCare Health - Sunbury #567 CBC # NPI/Ref # Court St - Circle Dr Sunbury, PA Phone: (570) Fax: (570) Milton Nursing and Rehabilitation LP CBC # NPI/Ref # Mahoning St Milton, PA Phone: (570) Fax: (570) Mount Carmel Nursing and Rehabilitation CBC # NPI/Ref # Locust Gap Hwy Mount Carmel, PA Phone: (570) Fax: (570) Mountain View A Nursing and Rehabilitation CBC # NPI/Ref # Trevorton Rd Coal Township, PA Phone: (570) Fax: (570) Nottingham Village CBC # NPI/Ref # Neitz Rd Northumberland, PA Phone: (570) Fax: (570) Sunbury Counity Health & Rehabilitation CBC # NPI/Ref # N 11th St Sunbury, PA Phone: (570) Fax: (570) Watsontown Nursing and Rehabilitation LP CBC # NPI/Ref # E 8th St Watsontown, PA Phone: (570) Fax: (570) Perry Kinkora Pythian Home Corporation CBC # NPI/Ref # Cove Rd Duncannon, PA Phone: (717) Fax: (717) Manor at Perry Village (The) CBC # NPI/Ref # E Main St New Bloomfield, PA Phone: (717) Fax: (717) Stonebridge Health and Rehabilitation CBC # NPI/Ref # Chandra Dr Duncannon, PA Phone: (717) Fax: (717) Schuylkill Broad Mountain Manor Extendicare CBC # NPI/Ref # W Laurel St Frackville, PA Phone: (570) Fax: (570) Golden Living - Terrace CBC # NPI/Ref # W Market St Pottsville, PA Phone: (570) Fax: (570) Hometown Nursing and Rehabilitation CBC # NPI/Ref # Lafayette Ave Tamaqua, PA Phone: (570) Fax: (570) ManorCare Health - Pottsville #566 CBC # NPI/Ref # Pulaski Dr Pottsville, PA Phone: (570) Fax: (570) Orwigsburg CBC # NPI/Ref # Orwigsburg Manor Dr Orwigsburg, PA Phone: (570) Fax: (570) Ridgeview Healthcare and Rehab LLC CBC # NPI/Ref # Pennsylvania Ave Shenandoah, PA Phone: (570) Fax: (570) Schuylkill CBC # NPI/Ref # Schuylkill Mnr Rd Pottsville, PA Phone: (570) Fax: (570) Schuylkill County Home Rest Haven CBC # NPI/Ref # University Dr Schuylkill Haven, PA Phone: (570) Fax: (570) Schuylkill Medical - South Jackson Street CBC # NPI/Ref # S Jackson St Pottsville, PA Phone: (570) Fax: (570) Seton Manor CBC # NPI/Ref # Seton Dr Orwigsburg, PA Phone: (570) Fax: (570) Shenandoah Manor Nursing CBC # NPI/Ref # E Washington St Shenandoah, PA Phone: (570) Fax: (570) St Lukes Miners Memorial Geriatric CBC # NPI/Ref # W Ruddle St Coaldale, PA Phone: (570) Fax: (570) Tremont Health and Rehabilitation CBC # NPI/Ref # Donaldson Rd Tremont, PA Phone: (570) Fax: (570) Snyder Manor at Penn Village (The) CBC # NPI/Ref # Rte 204 Selinsgrove, PA Phone: (570) Fax: (570) Union Buffalo Valley Lutheran Village CBC # NPI/Ref # Fairground Rd Lewisburg, PA Phone: (570) Fax: (570) RiverWoods CBC # NPI/Ref # River Rd Lewisburg, PA Phone: (570) Fax: (570) SKILLED NURSING FACILITIES Handicap Accessible Page 345

16 SKILLED NURSING FACILITIES Barbara J Egan Nursing and Rehabilitation CBC # NPI/Ref # Luther Rd Shrewsbury, PA Phone: (717) Fax: (717) Colonial Manor CBC # NPI/Ref # Colonial Ave, PA Phone: (717) Fax: (717) Hanover Hall CBC # NPI/Ref # Frederick St Hanover, PA Phone: (717) Fax: (717) Lutheran Nursing and Rehab at Sprenkle Dr CBC # NPI/Ref # Folkemer Cir, PA Phone: (717) Fax: (717) ManorCare Health - Dallastown #554 CBC # NPI/Ref # W Queen St Dallastown, PA Phone: (717) Fax: (717) ManorCare Health - Kingston Court #585 CBC # NPI/Ref # Kingston Ct, PA Phone: (717) Fax: (717) ManorCare Health - North #580 CBC # NPI/Ref # Barley Rd, PA Phone: (717) Fax: (717) ManorCare Health - South #581 CBC # NPI/Ref # Pauline Dr, PA Phone: (717) Fax: (717) Normandie Ridge CBC # NPI/Ref # Normandie Dr, PA Phone: (717) Fax: (717) Pleasant Acres Nursing and Rehabilitation CBC # NPI/Ref # Pleasant Acres Rd, PA Phone: (717) Fax: (717) Rest Haven - CBC # NPI/Ref # S George St, PA Phone: (717) Fax: (717) Skilled Care at Utz Terrace CBC # NPI/Ref # Sunset Dr Hanover, PA Phone: (717) Fax: (717) Handicap Accessible Page 346

17 The following section lists network ancillary providers. Referral Requirements ANCILLARY PROVIDERS For accurate information regarding referral requirements for SecureChoice SM, please refer to your Member Handbook. Preauthorization Requirements For accurate information regarding preauthorization requirements for SecureChoice SM, please refer to your Member Handbook. Important Notes This directory is accurate only as of the date the information was generated for this printing. To check the most current participation status of any particular provider, visit our website at capbluecross.com/healthypa or call the toll-free number on your ID card. You may also contact our Customer Service Department for SecureChoice SM Members at (TTY 711), Monday through Friday, 8:00 AM to 6:00 PM, or contact the provider directly to verify their participation in SecureChoice SM. If you have questions about your benefits or any other aspect of your health care coverage, please call the toll-free number on your ID card or contact our Customer Service Department for SecureChoice SM Members at (TTY 711), Monday through Friday, 8:00 AM to 6:00 PM. After normal business hours, you may leave a voice mail message and a Customer Service Representative will return your call during the next business day. Always present your Member identification card each time you seek medical services. For detailed information concerning your benefits, please refer to your Member Handbook. Page 347

18 Ambulance Adams Adams Caring Hearts Ambulance & Medical Transportation CBC # 39EA42 NPI/Ref # Fairfield Rd Gettysburg, PA Phone: (717) Fax: (866) Gettysburg Fire Department CBC # 39EA34 NPI/Ref # N Stratton St Gettysburg, PA Phone: (717) Fax: (717) White Rose Ambulance CBC # 39EA15 NPI/Ref # Fairfield Rd Gettysburg, PA Phone: (717) Fax: (717) City of Reading EMS CBC # 39EA31 NPI/Ref # Walnut St Reading, PA Phone: (610) Fax: (610) Exeter Ambulance Association CBC # 39EA50 NPI/Ref # Fairlane Rd Reading, PA Phone: (610) Fax: (610) KATS Kutztown Ambulance CBC # NPI/Ref # S Kemp Rd Kutztown, PA Phone: (610) Fax: (610) Regional EMS & Critical Care CBC # NPI/Ref # Holly Rd Hamburg, PA Phone: (610) Fax: (717) Carbon Regional EMS & Critical Care CBC # NPI/Ref # /2 N 3rd St ton, PA Phone: (610) Ambulance Mid-State Mobile Health Partners CBC # 39EA47 NPI/Ref # Long Ln Mechanicsburg, PA Phone: (717) Respect Ambulance Company CBC # NPI/Ref # Huel Ave Ste 100 Phone: (717) Fax: (717) Trust Ambulance CBC # NPI/Ref # Primrose Ave Phone: (717) Fax: (717) West Shore Emergency Medical Service CBC # 39EA02 NPI/Ref # Grandview Ave Ste 211 Phone: (717) Fax: (717) Counity Life Team CBC # 39EA03 NPI/Ref # Paxton St - Rear Harrisburg, PA Phone: (717) Fax: (717) Halifax Area Ambulance & Rescue Association CBC # NPI/Ref # Bunker Hill Halifax, PA Phone: (717) Fax: (717) Medical Express Ambulance Service CBC # 39EA48 NPI/Ref # Peters Mountain Rd Halifax, PA Phone: (717) Fax: (717) South Central Emergency Medical CBC # 39EA11 NPI/Ref # Allentown Blvd Harrisburg, PA Phone: (717) Fax: (717) Susquehanna Township EMS CBC # 39EA05 NPI/Ref # Short St Phone: (717) Fax: (717) Mont Alto Ambulance Association CBC # 39EA32 NPI/Ref # S Main St Mont Alto, PA Phone: (717) Fax: (717) EMS CBC # 39EA54 NPI/Ref # Lincoln Hwy E, PA Phone: (717) Fax: (717) Susquehanna Valley EMS CBC # 39EA44 NPI/Ref # Keller Ave, PA Phone: (717) Fax: (717) Cetronia Ambulance Corps CBC # 39EA07 NPI/Ref # Broadway Phone: (610) Fax: (610) City of Allentown EMS CBC # 39EA08 NPI/Ref # Chew St Allentown, PA Phone: (610) Fax: (610) Northern Ambulance Service CBC # 39EA63 NPI/Ref # Spring Hill Dr Schnecksville, PA Phone: (610) Fax: (610) City of Bethlehem EMS CBC # 39EA04 NPI/Ref # Stefko Blvd Bethlehem, PA Phone: (610) Fax: (610) Easton Emergency Squad CBC # 39EA35 NPI/Ref # Packer St Easton, PA Phone: (610) Fax: (610) Klecknersville Rangers Volunteer Fire Company CBC # 39EA25 NPI/Ref # Mountain View Dr Bath, PA Phone: (610) Fax: (610) Valley Transportation CBC # 39EA37 NPI/Ref # W Market St Bethlehem, PA Phone: (610) Fax: (610) Nazareth Volunteer Ambulance Corp CBC # 39EA30 NPI/Ref # S Broad St Nazareth, PA Phone: (610) Fax: (610) Regional Emergency Medical CBC # NPI/Ref # Snowhill Rd, PA Phone: (610) Fax: (610) Canal St, PA Phone: (610) Fax: (610) Suburban EMS CBC # 39EA09 NPI/Ref # Freemansburg Ave Easton, PA Phone: (610) Fax: (610) Schuylkill Penn-Mahoning Ambulance Association CBC # 39EA33 NPI/Ref # W Penn Pike New Ringgold, PA Phone: (570) Fax: (570) Regional EMS & Critical Care CBC # NPI/Ref # E Broad St Ste 300 Tamaqua, PA Phone: (570) Memorial Hospital CBC # 39EA20 NPI/Ref # Lifeline Medic S Belmont St, PA Phone: (717) Fax: (717) Quality Care Ambulance CBC # 39EA26 NPI/Ref # N Harrison St, PA Phone: (717) Fax: (717) White Rose Ambulance CBC # 39EA15 NPI/Ref # N Harrison St, PA Phone: (717) Fax: (717) Ambulatory Surgical for Digestive Health LP CBC # NPI/Ref # Reed Ave Ste 600 Phone: (610) Fax: (610) hire Eye Surgery LP CBC # NPI/Ref # Ridgewood Rd Phone: (610) Fax: (610) Pennsylvania Eye and Ear Surgery LLC CBC # NPI/Ref # Granite Pointe Dr Ste 200 Phone: (610) Fax: (610) Progressive Laser Surgical Institute CBC # NPI/Ref # Broadcasting Rd Reading, PA Phone: (610) Fax: (610) State Hill Surgi LLC CBC # NPI/Ref # Westview Dr Phone: (610) Fax: (610) Centre Penn State Hershey Endoscopy LLC CBC # 39SC01 NPI/Ref # Colonnade Way State College, PA Phone: (814) Fax: (814) UOC Surgical Ltd CBC # NPI/Ref # Regent Ct State College, PA Phone: (814) Fax: (814) Carlisle Endoscopy Ltd CBC # NPI/Ref # Alexander Spring Rd Carlisle, PA Phone: (717) Fax: (717) Digestive Disease Institute CBC # NPI/Ref # Poplar Church Rd Phone: (717) Fax: (717) Grandview Surgery and Laser CBC # NPI/Ref # Grandview Ave Ste 100 Phone: (717) Fax: (717) Ophthalmology and Surgical Inst of Central PA(The) CBC # NPI/Ref # Tyler Ct Carlisle, PA Phone: (717) Fax: (717) West Shore Endoscopy CBC # NPI/Ref # N 21st St Ste 102 Phone: (717) Fax: (717) Harrisburg Endoscopy and Surgery CBC # NPI/Ref # Union Deposit Rd Ste 110 Harrisburg, PA Phone: (717) Fax: (717) Hershey Endoscopy LLC CBC # NPI/Ref # W Governor Rd Ste 100 Hershey, PA Phone: (717) Fax: (717) Hershey Outpatient Surgery CBC # NPI/Ref # Hope Dr Hershey, PA Phone: (717) Fax: (717) ANCILLARY PROVIDERS Page 349

19 Ambulatory Surgical ANCILLARY PROVIDERS Ophthalmology Surgical CBC # NPI/Ref # Tuscarora St 2nd Fl Harrisburg, PA Phone: (717) Fax: (717) Pennsylvania Eye Surgery CBC # NPI/Ref # Linglestown Rd Harrisburg, PA Phone: (717) Fax: (717) PRISM for Spine and Pain Care CBC # NPI/Ref # Londonderry Rd Ste 100 Phone: (717) Fax: (717) Susquehanna Valley Surgery CBC # NPI/Ref # Londonderry Rd Ste 1 Phone: (717) Fax: (717) Chambersburg Endoscopy LLC CBC # NPI/Ref # th Ave Phone: (717) Fax: (717) Dr Roy A Himelfarb Surgery CBC # NPI/Ref # Norland Ave Ste 100 Phone: (717) Fax: (717) Ludwick Laser and Surgery CBC # NPI/Ref # th Ave Ste 101 Phone: (717) Fax: (717) for Spine Care at LNSA (The) CBC # NPI/Ref # Crooked Oak Dr, PA Phone: (717) Fax: (717) Mid-Atlantic GastroIntestinal CBC # NPI/Ref # Harrisburg Pike Ste 300, PA Phone: (717) Fax: (717) Mid-Atlantic GastroIntestinal II CBC # NPI/Ref # Oregon Pike Ephrata, PA Phone: (717) Fax: (717) NeuroSpine (The) CBC # NPI/Ref # Eden Rd Ste 201, PA Phone: (717) Fax: (717) North Pointe Surgery CBC # NPI/Ref # N Pointe Blvd, PA Phone: (717) Fax: (717) Physicians Surgery Ctr General LLC (The) CBC # NPI/Ref # Harrisburg Pike, PA Phone: (717) Fax: (717) Surgery of LP CBC # NPI/Ref # Plaza Blvd Ste 101, PA Phone: (717) Fax: (717) Physicians Surgical CBC # NPI/Ref # Quentin Rd, PA Phone: (717) Fax: (717) Mifflin Mifflin County Counity Surgical CBC # NPI/Ref # th St Lewistown, PA Phone: (717) Fax: (717) Bethlehem Endoscopy LLC CBC # NPI/Ref # Bethlehem Medical Arts Ctr 5325 Northgate Dr Ste 101 Phone: (610) Fax: (610) for Specialized Surgery LP (The) CBC # NPI/Ref # Baglyos Cir Ste 100 Bethlehem, PA Phone: (484) Fax: (484) Valley Eye Surgical CBC # NPI/Ref # Valley Pkwy Phone: (610) Fax: (610) Schuylkill Progressive Surgical Institute CBC # NPI/Ref # E Laurel Blvd Pottsville, PA Phone: (570) Fax: (570) Schuylkill Endoscopy CBC # NPI/Ref # Tunnel Rd Ste 103 Pottsville, PA Phone: (570) Fax: (570) Surgery of Pottsville LP CBC # NPI/Ref # Rte 61 Ste 6192 Pottsville, PA Phone: (570) Fax: (570) Union Betz Ophthalmology Associates ASC CBC # NPI/Ref # Enterprise Blvd Allenwood, PA Phone: (570) Fax: (570) Brookpark Surgery LLC CBC # NPI/Ref # Saint Mary St W Lewisburg, PA Phone: (570) Fax: (570) CPGI Endoscopy LLC CBC # NPI/Ref # Medical Park Dr Lewisburg, PA Phone: (570) Fax: (570) Hillside Endoscopy LLC CBC # NPI/Ref # Fame Ave Ste 240 Hanover, PA Phone: (717) Fax: (717) OSS Ambulatory Surgery CBC # NPI/Ref # Powder Mill Rd Ste 210, PA Phone: (717) Fax: (717) Adams Pain Specialists PC CBC # NPI/Ref # Fame Ave Ste 120 Hanover, PA Phone: (717) Fax: (717) Endoscopy LP CBC # NPI/Ref # Southfield Dr, PA Phone: (717) Fax: (717) Birthing RHPN Reading Birth CBC # NPI/Ref # New Holland Rd Reading, PA Phone: (610) Fax: (610) Birth Care and Family Health CBC # NPI/Ref # Georgetown Rd Christiana, PA Phone: (717) Fax: (717) Blue Distinction s for Bariatric Surgery Reading Hospital and Medical CBC # NPI/Ref # th Ave & Spruce St Reading, PA Phone: (610) Fax: (610) Milton S Hershey Medical (The) CBC # NPI/Ref # University Dr Hershey, PA Phone: (717) Fax: (717) PinnacleHealth Hospitals CBC # NPI/Ref # Counity Campus 4300 Londonderry Rd Phone: (717) Valley Hospital CBC # NPI/Ref # S Cedar Crest Blvd Allentown, PA Phone: (610) Fax: (484) Sacred Heart Hospital CBC # NPI/Ref # Chew St Allentown, PA Phone: (610) Fax: (610) St Lukes Hospital - Allentown Campus CBC # NPI/Ref # Hamilton St Phone: (610) Fax: (610) Blue Distinction s for Cardiac Care Reading Hospital and Medical CBC # NPI/Ref # th Ave & Spruce St Reading, PA Phone: (610) Fax: (610) St Joseph Medical CBC # NPI/Ref # Bernville Rd Reading, PA Phone: (610) Fax: (610) Regional Medical CBC # NPI/Ref # College Ave, PA Phone: (717) Fax: (717) Valley Hospital CBC # NPI/Ref # S Cedar Crest Blvd Allentown, PA Phone: (610) Fax: (484) Blue Distinction s for Complex & Rare Cancers Milton S Hershey Medical (The) CBC # NPI/Ref # University Dr Hershey, PA Phone: (717) Fax: (717) Valley Hospital CBC # NPI/Ref # S Cedar Crest Blvd Allentown, PA Phone: (610) Fax: (484) Blue Distinction s for Knee & Hip Replacement Reading Hospital and Medical CBC # NPI/Ref # th Ave & Spruce St Reading, PA Phone: (610) Fax: (610) Centre Mount Nittany Medical CBC # NPI/Ref # E Park Ave State College, PA Phone: (814) Fax: (814) Chambersburg Hospital CBC # NPI/Ref # N 7th St Phone: (717) Fax: (717) General Hospital CBC # NPI/Ref # N Duke St, PA Phone: (717) Fax: (717) Page 350

20 Diagnostic Imaging Valley Hospital CBC # NPI/Ref # S Cedar Crest Blvd Allentown, PA Phone: (610) Fax: (484) Blue Distinction s for Spine Surgery Reading Hospital and Medical CBC # NPI/Ref # th Ave & Spruce St Reading, PA Phone: (610) Fax: (610) Centre Mount Nittany Medical CBC # NPI/Ref # E Park Ave State College, PA Phone: (814) Fax: (814) Milton S Hershey Medical (The) CBC # NPI/Ref # University Dr Hershey, PA Phone: (717) Fax: (717) Valley Hospital CBC # NPI/Ref # S Cedar Crest Blvd Allentown, PA Phone: (610) Fax: (484) Blue Distinction s for Transplants (Bone Marrow) Milton S Hershey Medical (The) CBC # NPI/Ref # University Dr Hershey, PA Phone: (717) Fax: (717) Blue Distinction s for Transplants (Heart) Milton S Hershey Medical (The) CBC # NPI/Ref # University Dr Hershey, PA Phone: (717) Fax: (717) Blue Distinction s for Transplants (Liver) Milton S Hershey Medical (The) CBC # NPI/Ref # University Dr Hershey, PA Phone: (717) Fax: (717) Blue Distinction s+ for Cardiac Care Holy Spirit Hospital CBC # NPI/Ref # N 21st St Phone: (717) Fax: (717) Milton S Hershey Medical (The) CBC # NPI/Ref # University Dr Hershey, PA Phone: (717) Fax: (717) PinnacleHealth Hospitals CBC # NPI/Ref # Harrisburg Campus 111 S Front St Harrisburg, PA Phone: (717) Fax: (717) General Hospital CBC # NPI/Ref # N Duke St, PA Phone: (717) Fax: (717) The Good Samaritan Hospital of PA CBC # NPI/Ref # th & Walnut Sts, PA Phone: (717) Fax: (717) Valley Hospital CBC # NPI/Ref # S Cedar Crest Blvd Allentown, PA Phone: (610) Fax: (484) Valley Hospital - Muhlenberg CBC # NPI/Ref # Schoenersville Rd Phone: (610) Fax: (484) St Lukes Hospital CBC # NPI/Ref # Ostrum St Bethlehem, PA Phone: (610) Fax: (610) Blue Distinction s+ for Knee & Hip Replacement Holy Spirit Hospital CBC # NPI/Ref # N 21st St Phone: (717) Fax: (717) Milton S Hershey Medical (The) CBC # NPI/Ref # University Dr Hershey, PA Phone: (717) Fax: (717) PinnacleHealth Hospitals CBC # NPI/Ref # Counity Campus 4300 Londonderry Rd Phone: (717) Harrisburg Campus 111 S Front St Harrisburg, PA Phone: (717) Fax: (717) Regional Medical CBC # NPI/Ref # College Ave, PA Phone: (717) Fax: (717) Valley Hospital CBC # NPI/Ref # S Cedar Crest Blvd Allentown, PA Phone: (610) Fax: (484) Hanover Hospital CBC # NPI/Ref # Highland Ave Hanover, PA Phone: (717) Fax: (717) Blue Distinction s+ for Spine Surgery Holy Spirit Hospital CBC # NPI/Ref # N 21st St Phone: (717) Fax: (717) PinnacleHealth Hospitals CBC # NPI/Ref # Counity Campus 4300 Londonderry Rd Phone: (717) Harrisburg Campus 111 S Front St Harrisburg, PA Phone: (717) Fax: (717) Valley Hospital CBC # NPI/Ref # S Cedar Crest Blvd Allentown, PA Phone: (610) Fax: (484) Diagnostic Imaging Adams Adams Diagnostic Imaging LLC CBC # NPI/Ref # Expedition Trl Ste 102 Gettysburg, PA Phone: (717) Fax: (717) Quantum Imaging and Therapeutic Associates CBC # NPI/Ref # New Oxford Diagnostic Ctr 5616 Rd New Oxford, PA Phone: (717) Fax: (717) Diagnostic Health - Reading CBC # NPI/Ref # hire Blvd Ste 500 Reading, PA Phone: (610) Fax: (610) Lackawanna Mobile X-ray CBC # NPI/Ref # Allentown Pike Reading, PA Phone: (800) Blair 611 Magnetic Imaging Associates CBC # NPI/Ref # Fairway Dr Ste 1 Altoona, PA Phone: (814) Fax: (814) Centre 611 Magnetic Imaging Associates CBC # NPI/Ref # University Dr State College, PA Phone: (814) Fax: (814) Tristan Radiology Specialists PC CBC # NPI/Ref # University Dr Ste 115 State College, PA Phone: (814) Columbia Susquehanna Valley Diagnostic Imaging CBC # NPI/Ref # Lows Rd Ste 317 Bloomsburg, PA Phone: (570) Fax: (570) OSS Health - Diagnostic Imaging CBC # NPI/Ref # Century Dr Mechanicsburg, PA Phone: (717) Fax: (717) Quantum Imaging and Therapeutic Associates CBC # NPI/Ref # Lemoyne Sq Ste 102 Lemoyne, PA Phone: (717) Waterford Dr Mechanicsburg, PA Phone: (717) Fax: (717) Trindle Rd Phone: (717) Carlisle Imaging 2 Jennifer Ct Ste 2 Carlisle, PA Phone: (717) Fax: (717) Carlisle Regional Medical 361 Alexander Spring Rd Carlisle, PA Phone: (717) Fax: (717) Fredrickson Outpatient Ctr 2015 Technology Pkwy Mechanicsburg, PA Phone: (717) Fax: (717) Holy Spirit Carlisle Ctr 1211 Forge Rd Carlisle, PA Phone: (717) Fax: (717) Holy Spirit Hospital 503 N 21st St Phone: (717) Fax: (717) Holy Spirit Mechanicsburg Ctr 405 St Johns Church Rd Phone: (717) Fax: (717) Holy Spirit Outpatient Imaging 890 Poplar Church Rd Phone: (717) Fax: (717) Holy Spirit Silver Spg Ctr 3 Flowers Dr Mechanicsburg, PA Phone: (717) Imaging of Lemoyne 50 N 12th St Lemoyne, PA Phone: (717) Fax: (717) ANCILLARY PROVIDERS Page 351

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