PROVIDER2015DIRECTORY

Transcription

1 PROVIDER2015DIRECTORY (Printed 11/2014) SecureChoiceSM Hospitals, Behavioral Health Care Facilities, SNFs, Ancillaries, and Clinical Laboratories 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 1

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) Centre Mount Nittany Medical CBC # NPI/Ref # E Park Ave State College, PA Phone: (814) Fax: (814) 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 # 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 # S Front St Harrisburg, PA Phone: (717) Fax: (717) Counity Campus 4300 Londonderry Rd Phone: (717) Franklin 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) Good Samaritan Hospital 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) for Orthopedic Medicine 4815 Tilghman St Allentown, PA Phone: (610) Sacred Heart Hospital CBC # NPI/Ref # Chew St Allentown, PA Phone: (610) Fax: (610) St Lukes Hospital - Allentown Campus CBC # NPI/Ref # Hamilton St Allentown, 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) Acute Care Hospital Outpatient Site 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 # Fredrickson Outpatient 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 Camp Hill 240 Grandview Ave Phone: (717) Fax: (717) PinnacleHealth Imaging at Heritage 3 Walnut St Lemoyne, PA Phone: (717) Fax: (717) PinnacleHealth Imaging at Silver Spring 21 Waterford Dr Mechanicsburg, PA Phone: (717) Fax: (717) PinnacleHealth Lab Srvcs at Silver Sprg 21 Waterford Dr Mechanicsburg, PA Phone: (717) Fax: (717) PinnacleHealth Ortenzio Cancer Ctr 2035 Technology Pkwy Mechanicsburg, PA Phone: (717) Fax: (717) PinnacleHealth Physical Therapy Fredrickson Outpatient 2015 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 Lab Svcs Belvedere Med Ctr 850 Walnut Bottom Rd Ste 104 Carlisle, 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) HOSPITALS For a list of services offered at Acute Care Hospital Outpatient Sites, please contact the facility directly. 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4 Acute Care Hospital Outpatient Site HOSPITALS HSH East Shore Laboratory 2808 Old Post Rd Phone: (717) PinnacleHealth Hospitals CBC # NPI/Ref # Adams Dr Huelstown, PA Phone: (717) Fax: (717) PinnacleHealth Bloom Diagnostic Ctr 4310 Londonderry Rd Phone: (717) 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 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 Imaging at West Hanover 8012 Bretz Dr Harrisburg, 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 Lab Svcs at West Hanover 8012 Bretz Dr Harrisburg, PA 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 Elizabethtown 125 E Main St Elizabethville, PA Phone: (717) Fax: (717) Polyclinic Campus 2501 N 3rd St Phone: (717) Women's Cancer Ctr - PinnacleHealth Hosp 3901 N Front St Phone: (717) Fax: (717) Franklin PinnacleHealth Hospitals CBC # NPI/Ref # PinnacleHealth Cardiovascular Institute 757 Norland Ave Ste 205 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) Good Samaritan Hospital CBC # NPI/Ref # GSH Ambulatory Services 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 E County 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 Services Jonestown Ctr 100 Queen St Jonestown, PA Phone: (717) Fax: (717) Perry Holy Spirit Hospital CBC # NPI/Ref # Duncannon Xray & Maography 510 New Bloomfield Rd Duncannon, PA Phone: (717) PinnacleHealth Hospitals CBC # NPI/Ref # PinnacleHealth Imaging at Newport 32 W Shortcut Dr 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 # PinnacleHealth Imaging at Dillsburg 1 Trinity Dr E Dillsburg, PA Phone: (717) Fax: (717) PinnacleHealth Lab Svcs at Dillsburg 1 Trinity Dr Dillsburg, PA Phone: (717) Fax: (717) PinnacleHealth PT of Dillsburg 860 N US 15 Dillsburg, PA Phone: (717) Fax: (717) 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 Maidencreek Towne Ctr 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) Geisinger HEALTHSOUTH Rehab Ctr of Berwick 2202 W Front St Berwick, PA Phone: (570) Fax: (570) Geisinger HEALTHSOUTH Rehab Ctr of Bloomsburg 415 Central Rd Bloomsburg, PA Phone: (570) Fax: (570) HEALTHSOUTH Rehabilitation of Mechanicsburg CBC # NPI/Ref # Blvd Mechanicsburg, PA Phone: (717) Fax: (717) Penn State Hershey Rehabilitation LLC CBC # NPI/Ref # Old W Chocolate Ave Huelstown, PA Phone: (717) Fax: (717) Handicap Accessible Page 4 For a list of services offered at Acute Care Hospital Outpatient Sites, please contact the facility directly.

5 Rehabilitation Unit Juniata HEALTHSOUTH Nittany Valley Rehabilitation Hospital CBC # NPI/Ref # HEALTHSOUTH O/P Rehab Ctr 4 Industrial Park Rd Mifflintown, 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 Sacred Heart Living by Saucon Crk 4851 Saucon Creek Rd Valley, PA Phone: (610) Fax: (610) Good Shep O/P Therapy Whitehall Mnr Assisted Living th St Whitehall, PA Phone: (610) Fax: (610) Good Shep PT - Coopersburg 101 S Main St 3rd Fl Coopersburg, PA Phone: (610) Fax: (610) Good Shep Rehab - Laurys Station Riverside Prof Ctr Ste Wynnwood Dr Rte 145 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) Geisinger 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 Sacred Heart Sr Living by Crk 602 E 21st St, PA Phone: (610) Fax: (610) Good Shep O/P Therapy Saucon Valley Mnr 1050 Main St Hellertown, PA Phone: (610) Fax: (610) Good Shep Rehab - Pediatric Unit 2855 Schoenersville Rd Phone: (610) Fax: (610) Good Shepherd Physical Therapy N Bethlehem/CORE Physical Therapy 3201 Highfield Dr Ste F Bethlehem, PA Phone: (610) Fax: (610) Northumberland Geisinger HEALTHSOUTH Rehabilitation Hospital CBC # NPI/Ref # Geisinger HEALTHSOUTH Rehab Ctr of Kulpmont 3 Vermont Dr Kulpmont, PA Phone: (570) Fax: (570) Geisinger HEALTHSOUTH Rehab Ctr of Milton 155 Arch St Milton, PA Phone: (570) Fax: (570) Snyder Geisinger HEALTHSOUTH Rehabilitation Hospital CBC # NPI/Ref # Geisinger HEALTHSOUTH Rehab Ctr of 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 Unit CBC # 39T044 NPI/Ref # Papermill Rd Phone: (484) Fax: (484) Centre HEALTHSOUTH Nittany Valley Rehabilitation Hospital Brain Treatment Unit 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 Unit CBC # 39T058 NPI/Ref # Village Dr Ste 4 Carlisle, PA Phone: (717) Fax: (717) HEALTHSOUTH Rehabilitation of Mechicsburg Brain Treatment Unit CBC # 39T310 NPI/Ref # Blvd Mechanicsburg, PA Phone: (717) Fax: (717) PinnacleHealth Hospitals Rehabilitation Unit CBC # 39T067 NPI/Ref # Helen M Simpson Rehab Hosp PinnacleHealth Co Campus 4300 Londonderry Rd Phone: (717) Franklin Chambersburg Hospital Rehabilitation Unit CBC # 39T151 NPI/Ref # N 7th St Phone: (717) Fax: (717) Regional Medical Rehabilitation Unit 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 Unit 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) HOSPITALS Handicap Accessible Page 5

6 Rehabilitation Unit HOSPITALS Union Evangelical Counity Hospital Acute Rehab Unit CBC # 39T013 NPI/Ref # Hospital Dr Lewisburg, PA Phone: (570) Fax: (570) HEALTHSOUTH Rehabilitation Hospital of Brain Treatment Unit CBC # 39T337 NPI/Ref # Normandie Dr, PA Phone: (717) Fax: (717) Handicap Accessible Page 6

7 23-Hour Psych Observation 23-Hour Psych Observation Regional Medical CBC # NPI/Ref # College Ave, PA Phone: (717) Fax: (717) Crisis Stabilization - Outpatient Northumberland Sunbury Counity Hospital CBC # NPI/Ref # N 11th St Sunbury, PA Phone: (570) Hospital CBC # NPI/Ref # S George St, PA Phone: (717) Fax: (717) Electro Convulsive Therapy - Inpatient Reading Hospital and Medical CBC # NPI/Ref # th Ave & Spruce 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 # N 3rd St Phone: (717) Fax: (717) Sacred Heart Hospital CBC # NPI/Ref # W Chew St Allentown, PA Phone: (610) Fax: (610) Hospital CBC # NPI/Ref # S George St, PA Phone: (717) Fax: (717) Electro Convulsive Therapy - Outpatient Reading Hospital and Medical CBC # NPI/Ref # th Ave & Spruce 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 # N 3rd St Phone: (717) Fax: (717) Sacred Heart Hospital CBC # NPI/Ref # W Chew St Allentown, PA Phone: (610) Fax: (610) Hospital CBC # NPI/Ref # S George St, PA Phone: (717) Fax: (717) Outpatient Bridge Appointment Program 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: (610) Fax: (610) Outpatient Psychiatric 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) 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) 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) Haven House CBC # NPI/Ref # N 2nd St Allentown, PA Phone: (610) Fax: (610) Omni Health Services CBC # NPI/Ref # Hamilton St Ste 100 Allentown, PA Phone: (484) Fax: (484) Northeastern Services CBC # NPI/Ref # E Broad St Ste O-00 Bethlehem, PA Phone: (610) Fax: (610) Outpatient Substance Abuse Disorders Adams Pennsylvania Counseling Services CBC # NPI/Ref # St Gettysburg, PA Phone: (717) Fax: (717) Counseling CBC # NPI/Ref # Penn St Reading, PA Phone: (610) Fax: (610) Pennsylvania Counseling Services 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: (610) Fax: (610) 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) Reading Hospital for Mental health CBC # NPI/Ref # Kutztown Boehm Science Kutztown Rd Kutztown, PA Phone: (610) New Insights CBC # NPI/Ref # State St Lemoyne, 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 Services CBC # NPI/Ref # Locust Ln Phone: (717) Fax: (717) Franklin Pennsylvania Counseling Services CBC # NPI/Ref # S Main St Phone: (717) Fax: (717) Freedom CBC # NPI/Ref # N Lime St, PA Phone: (717) Fax: (717) Pennsylvania Counseling Services CBC # NPI/Ref # Pearl St, PA Phone: (717) Fax: (717) Pennsylvania Counseling Services CBC # NPI/Ref # St, PA Phone: (717) Fax: (717) Habit Opco 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 Services CBC # NPI/Ref # Delaware Ave Bethlehem, PA Phone: (610) Fax: (610) Raft Treatment LLC CBC # NPI/Ref # Broad St Ste 101 Eaus, PA Phone: (610) Fax: (610) BEHAVIORAL HEALTH FACILITIES Handicap Accessible Page 7

8 Outpatient Substance Abuse Disorders BEHAVIORAL HEALTH FACILITIES Counity Services Foundation CBC # NPI/Ref # Main St Bethlehem, PA Phone: (610) Net Treatment Services CBC # NPI/Ref # S 3rd St Ste 508 Easton, PA Phone: (610) Fax: (610) Northeastern Services CBC # NPI/Ref # E Broad St Ste O-00 Bethlehem, PA Phone: (610) Fax: (610) Recovery Revolution CBC # NPI/Ref # Broadway Bangor, PA Phone: (610) Fax: (610) New Insights CBC # NPI/Ref # Carlisle Ave, PA Phone: (717) Fax: (717) Pennsylvania Counseling Services 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) 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) Centre Universal Counity Behavioral Health CBC # NPI/Ref # Match Factory Pl Bellefonte, PA Phone: (814) Universal Counity Behavioral Health CBC # NPI/Ref # Walton St Philipsburg, PA Phone: (814) Fax: (814) 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) 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: (610) Fax: (610) Centre Universal Counity Behavioral Health CBC # NPI/Ref # Match Factory Pl Bellefonte, PA Phone: (814) Universal Counity Behavioral Health CBC # NPI/Ref # Walton St Philipsburg, 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) 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) Philhaven Hospital CBC # NPI/Ref # Butler Rd Mount Gretna, PA Phone: (717) Fax: (717) 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 Services CBC # NPI/Ref # Frederick St Hanover, PA Phone: (717) Fax: (717) 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: (610) Fax: (610) 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) 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) 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) Northumberland Sunbury Counity Hospital CBC # NPI/Ref # N 11th St Sunbury, PA Phone: (570) Hospital CBC # NPI/Ref # S George St, PA Phone: (717) Fax: (717) Substance Abuse Detox - Intensive Outpatient Adams Pennsylvania Counseling Services CBC # NPI/Ref # St Gettysburg, PA Phone: (717) Fax: (717) Counseling CBC # NPI/Ref # Penn St Reading, PA Phone: (610) Fax: (610) Pennsylvania Counseling Services CBC # NPI/Ref # Penn St Reading, PA Phone: (610) Fax: (610) Pennsylvania Counseling Services CBC # NPI/Ref # S 5th St Reading, PA Phone: (610) Fax: (610) Handicap Accessible Page 8

9 Substance Abuse Rehab - Inpatient 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) Mazzitti and Sullivan CBC # NPI/Ref # N Front St Phone: (717) Fax: (717) Pennsylvania Counseling Services CBC # NPI/Ref # Locust Ln Phone: (717) Fax: (717) Franklin Pennsylvania Counseling Services CBC # NPI/Ref # S Main St Phone: (717) Fax: (717) Freedom CBC # NPI/Ref # N Lime St, PA Phone: (717) Fax: (717) Pennsylvania Counseling Services CBC # NPI/Ref # Pearl St, PA Phone: (717) Fax: (717) Pennsylvania Counseling Services CBC # NPI/Ref # St, PA Phone: (717) Fax: (717) 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 Services CBC # NPI/Ref # Delaware Ave Bethlehem, PA Phone: (610) Fax: (610) Raft Treatment LLC CBC # NPI/Ref # Broad St Ste 101 Eaus, PA Phone: (610) Fax: (610) Net Treatment Services CBC # NPI/Ref # S 3rd St Ste 508 Easton, PA Phone: (610) Fax: (610) New Insights CBC # NPI/Ref # Carlisle Ave, PA Phone: (717) Fax: (717) Pennsylvania Counseling Services 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) Livengrin Foundation CBC # NPI/Ref # Hanover Office Plz 961 Marcon Blvd Ste 304 Allentown, PA Phone: (610) Fax: (610) Counity Services Foundation CBC # NPI/Ref # Main St Bethlehem, PA Phone: (610) New Insights CBC # NPI/Ref # Carlisle Ave, PA Phone: (717) Fax: (717) Substance Abuse Rehab - Inpatient Reading Hospital and Medical CBC # NPI/Ref # Buttonwood St Reading, PA Phone: (610) Fax: (484) Holy Spirit Hospital CBC # NPI/Ref # N 21st St Phone: (717) Fax: (717) Gaudenzia Outpatient Services CBC # NPI/Ref # Chambers Hill Rd Harrisburg, PA Phone: (717) Fax: (717) Colonial House CBC # NPI/Ref # Woodberry Rd, PA Phone: (717) Fax: (717) BEHAVIORAL HEALTH FACILITIES Handicap Accessible Page 9

10 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 11

11 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) Kindred Transitional Care and Rehab - Wyomissing CBC # NPI/Ref # E Wyomissing Blvd Reading, PA 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) Laureldale #562 CBC # NPI/Ref # Elizabeth Ave Laureldale, PA Phone: (610) Fax: (610) Sinking Springs #576 CBC # NPI/Ref # Windmill Rd Sinking Spring, PA Phone: (610) Fax: (610) 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) Centre Centre Crest CBC # NPI/Ref # E Howard St Bellefonte, PA Phone: (814) Fax: (814) Fairways at Brookline CBC # NPI/Ref # Cliffside Dr State College, PA Phone: (814) Fax: (814) Hearthside A Nursing and Rehabilitation (The) CBC # NPI/Ref # Waupelani Dr 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 of County 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) Camp Hill #583 CBC # NPI/Ref # Market St Phone: (717) Fax: (717) 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 13

12 Franklin SKILLED NURSING FACILITIES Franklin Falling Spring Nursing and Rehabilitation CBC # NPI/Ref # Franklin Farm Ln Chambersburg, PA Phone: (717) Fax: (717) 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) Elizabethtown #582 CBC # NPI/Ref # S Market St Elizabethtown, PA Phone: (717) Fax: (717) #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 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) #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 Allentown, PA 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 Allentown, PA Phone: (610) Fax: (610) Luther Crest Nursing Facility CBC # NPI/Ref # Hausman Rd Allentown, PA Phone: (610) Fax: (610) Allentown #481 CBC # NPI/Ref # S Cedar Crest Blvd Phone: (610) Fax: (610) Handicap Accessible Page 14

13 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 Allentown, PA 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) Bethlehem (2021) #555 CBC # NPI/Ref # Westgate Dr Phone: (610) Fax: (610) 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) Northumberland Golden Living - Mansion CBC # NPI/Ref # Market St Sunbury, PA Phone: (570) Fax: (570) 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) 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) Barbara J Egan Nursing and Rehabilitation CBC # NPI/Ref # Luther Rd Shrewsbury, PA Phone: (717) Fax: (717) SKILLED NURSING FACILITIES Handicap Accessible Page 15

14 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) Dallastown #554 CBC # NPI/Ref # W Queen St Dallastown, PA Phone: (717) Fax: (717) Kingston Court #585 CBC # NPI/Ref # Kingston Ct, PA Phone: (717) Fax: (717) North #580 CBC # NPI/Ref # Barley Rd, PA Phone: (717) Fax: (717) 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) SKILLED NURSING FACILITIES Handicap Accessible Page 16

15 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 17

16 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 Penn Choice Ambulance CBC # 39EA51 NPI/Ref # Hartzdale Dr Ste 708 Phone: (717) Fax: (215) 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 Services CBC # 39EA11 NPI/Ref # Allentown Blvd Harrisburg, PA Phone: (717) Fax: (717) Franklin 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) Excelsior EMS CBC # 39EA55 NPI/Ref # W Bethany Rd Newmanstown, PA Phone: (610) Fax: (610) Cetronia Ambulance Corps CBC # 39EA07 NPI/Ref # Broadway Allentown, PA 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) Global Medical Transportation Services CBC # 39EA37 NPI/Ref # W Market St Bethlehem, PA Phone: (610) Fax: (610) Klecknersville Rangers Volunteer Fire Company CBC # 39EA25 NPI/Ref # Mountain View Dr Bath, PA Phone: (610) Fax: (610) Lifestar Response New Jersey CBC # 39EA38 NPI/Ref # Eaton Ave Bethlehem, PA Phone: (888) Fax: (888) Nazareth Volunteer Ambulance Corp CBC # 39EA30 NPI/Ref # S Broad St Nazareth, PA Phone: (610) Fax: (610) Regional Emergency Medical Services 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 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) 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) 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) 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) 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) Susquehanna Valley Surgery CBC # NPI/Ref # Londonderry Rd Ste 1 Phone: (717) Fax: (717) Franklin 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) Physicians Surgery General LLC (The) CBC # NPI/Ref # Harrisburg Pike, PA Phone: (717) Fax: (717) ANCILLARY PROVIDERS Page 19

17 Ambulatory Surgical ANCILLARY PROVIDERS Surgery of LP CBC # NPI/Ref # Plaza Blvd Ste 101, 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) Valley Eye Surgical CBC # NPI/Ref # Valley Pkwy Phone: (610) Fax: (610) Schuylkill 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) Hillside Endoscopy LLC CBC # NPI/Ref # Fame Ave Ste 240 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 Services 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 Allentown, PA 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) Franklin 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) 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 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 # S Front St Harrisburg, PA Phone: (717) Fax: (717) General Hospital CBC # NPI/Ref # N Duke St, PA Phone: (717) Fax: (717) Good Samaritan Hospital 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) Page 20

18 Diagnostic Imaging 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 # S Front St Harrisburg, PA Phone: (717) Fax: (717) Counity Campus 4300 Londonderry Rd Phone: (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 # S Front St Harrisburg, PA Phone: (717) Fax: (717) Counity Campus 4300 Londonderry Rd Phone: (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) Valley Diagnostic Imaging CBC # NPI/Ref # Hawk Ridge Dr Hamburg, PA Phone: (610) Fax: (610) Blair 611 Magnetic Imaging Associates CBC # NPI/Ref # Fairway Dr Ste 1 Altoona, PA Phone: (814) Fax: (814) Bucks Ultrasound Services CBC # NPI/Ref # Blacksmith Rd Ste 200 Newtown, PA Phone: (215) Fax: (215) Centre 611 Magnetic Imaging Associates CBC # NPI/Ref # University Dr State College, PA Phone: (814) Fax: (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 Services 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 Medical Arts Bldg 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) Magnetic Imaging Ctr 4665 Trindle Rd Mechanicsburg, PA Phone: (717) Medical Arts Bldg Imaging Svcs 220 Wilson St Ste 102 Carlisle, PA Phone: (717) Fax: (717) Oakwood Breast Care Ctr 880 Century Dr Mechanicsburg, PA Phone: (717) Seidle Memorial Hospital 120 S Filbert St Mechanicsburg, PA Phone: (717) Fax: (717) Smith Radiology CBC # NPI/Ref # Bridge St New, PA Phone: (717) Fax: (717) Tristan Radiology Specialists PC CBC # NPI/Ref # PinnacleHealth 240 Grandview Ave Phone: (717) Fax: (717) Tristan Radiology Specialist - PWHC 5 Brookwood Ave Carlisle, PA Phone: (717) Tristan Radiology Specialist - PWHW 1 Lemoyne Plz Ste 201 Lemoyne, PA Phone: (717) Tristan Radiology Specialist PC 3 Walnut St Ste 100 Lemoyne, PA Phone: (717) Fax: (717) Walnut Bottom Radiology CBC # NPI/Ref # Walnut Bottom Rd Carlisle, PA Phone: (717) Fax: (717) Med Health Services Management LP CBC # NPI/Ref # Allegheny St, PA Phone: (412) Fax: (412) PinnacleHealth Family Care - Millersburg - Diagnostics CBC # NPI/Ref # Evelyn Dr Millersburg, PA Phone: (717) Fax: (717) Quantum Imaging and Therapeutic Associates CBC # NPI/Ref # W Harrisburg Pike Middletown, PA Phone: (717) Fax: (717) Counity General Osteopathic Hospital 4300 Londonderry Rd Harrisburg, PA Phone: (717) Fax: (717) Counity Imaging MRI 865 S Arlington Ave Phone: (717) Fax: (717) Harrisburg Hospital 111 S Front St Harrisburg, PA Phone: (717) Fax: (717) Holy Spirit Progress 20 Capital Dr Phone: (717) Fax: (717) Orthopedic Institute of PA-East 450 Powers Ave Phone: (717) PinnacleHealth at West Hanover 8012 Bretz Dr Huelstown, PA Phone: (717) Fax: (717) PinnacleHealth Imaging at Millersburg 1000 Evelyn Dr Millersburg, PA Phone: (717) PinnacleHealth Imaging of Lower Paxton 2310 Patton Rd Harrisburg, PA Phone: (717) Polyclinic Medical Ctr 2601 N 3rd St Phone: (717) Fax: (717) Tristan Radiology Specialists PC CBC # NPI/Ref # Adams Dr Huelstown, PA Phone: (717) Fax: (717) PinnacleHealth 2808 Old Post Rd Phone: (717) Fax: (717) PinnacleHealth 32 Northeast Dr Ste 201 Hershey, PA Phone: (717) Fax: (717) PinnacleHealth 4518 Union Deposit Rd Harrisburg, PA Phone: (717) Fax: (717) Tristan Radiology Specialist - PWHE 810 Sir Thomas Ct Phone: (717) Tristan Radiology Specialist- Womens 1st 4700 Union Deposit Rd Ste 140 Harrisburg, PA Phone: (717) ANCILLARY PROVIDERS Page 21

19 Diagnostic Imaging Fulton ANCILLARY PROVIDERS Fulton Fulton Diagnostic Radiology LLC CBC # NPI/Ref # Fulton County Medical Ctr 214 Peach Orchard Rd Mc Connellsburg, PA Phone: (717) Fax: (717) PET Partnership LLP CBC # NPI/Ref # Harrisburg Pke, PA Phone: (717) Fax: (717) Radiology Associates Ltd CBC # NPI/Ref # Kissel Hill Health Ctr 51 Peters Rd Lititz, PA Phone: (717) Fax: (717) Gen Hlth Campus Diagnostic Imaging 2100 Harrisburg Pike, PA Phone: (717) Fax: (717) Gen Hlth Campus Radiation Oncology 2102 Harrisburg Pike, PA Phone: (717) Fax: (717) General - Norlanco 424 Cloverleaf Rd Elizabethtown, PA Phone: (717) Fax: (717) General Hospital 555 N Duke St, PA Phone: (717) Fax: (717) General Women & Babies Hosp 690 Good Dr, PA Phone: (717) Fax: (717) Regional Imaging Associates PC CBC # NPI/Ref # Highlands Dr Lititz, PA Phone: (717) Reg Med Ctr 250 College Ave, PA Phone: (717) Fax: (717) Diagnostic Imaging CBC # NPI/Ref # Isabel Dr, PA Phone: (717) Fax: (717) Cedar Crest Imaging CBC # NPI/Ref # S Cedar Crest Blvd Ste 102 Phone: (610) Fax: (610) Extremity Imaging Partners CBC # NPI/Ref # Hamilton Blvd Ste Ste 102 Allentown, PA Phone: (866) Magnetic Imaging CBC # NPI/Ref # S Cedar Crest Blvd Phone: (610) Fax: (610) S Cedar Crest Blvd Phone: (610) Fax: (610) Valley Diagnostic Imaging CBC # NPI/Ref # S Cedar Crest Blvd Ste 104 Phone: (610) Fax: (610) S Cedar Crest Blvd Ste 401 Phone: (610) Fax: (610) S Cedar Crest Blvd Ste 101 Phone: (610) Fax: (610) OAA Orthopaedic Specialists Imaging CBC # NPI/Ref # Cetronia Rd Ste 101 Allentown, PA Phone: (610) Fax: (866) Open Air MRI of Allentown CBC # NPI/Ref # S Cedar Crest Blvd Ste 102 Phone: (610) Fax: (610) VSAS Orthopaedics - MRI CBC # NPI/Ref # Ctr for Advanced Hlth Care 1250 S Cedar Crest Blvd Ste 110 Phone: (610) Fax: (610) Monroe Star Open MRI CBC # NPI/Ref # Rte 611 Stroudsburg, PA Phone: (570) Fax: (570) Montgomery Oaks Radiology CBC # NPI/Ref # Cresson Blvd Ste 100 Oaks, PA Phone: (610) Fax: (610) Advanced Radiology and Cardiovascular CBC # NPI/Ref # Easton Nazareth Hwy Easton, PA Phone: (610) Fax: (610) Easton Radiology Associates PC CBC # NPI/Ref # Easton Radiology Breast Imaging 3735 Nazareth Rd Ste 103 Easton, PA Phone: (610) Fax: (610) Easton Radiology Diagnostic Imaging CBC # NPI/Ref # Ferry St Easton, PA Phone: (610) Fax: (610) Magnetic Imaging CBC # NPI/Ref # Bathgate Dr Phone: (610) Fax: (610) Valley Diagnostic Imaging CBC # NPI/Ref # Emrick Blvd Bethlehem, PA Phone: (610) Fax: (610) MRI of Easton CBC # NPI/Ref # Kingston Rd Easton, PA Phone: (610) Fax: (610) Radiology and MRI of Bethlehem CBC # NPI/Ref # Northgate Dr Ste 100 Phone: (610) Fax: (610) Star Open MRI CBC # NPI/Ref # Easton Nazareth Hwy Ste 102 Easton, PA Phone: (610) Fax: (610) Perry Quantum Imaging and Therapeutic Associates CBC # NPI/Ref # Holy Spirit Duncannon Ctr 51 Business Campus Way Ste 100 Duncannon, PA Phone: (717) Fax: (717) Perry Hlth Ctr Imaging Svcs 110 Montour Rd Loysville, PA Phone: (717) Fax: (717) PinnacleHealth Imaging at Newport 28 W Shortcut Rd Newport, PA Phone: (717) Fax: (717) Schuylkill Lackawanna Mobile X-ray CBC # NPI/Ref # Schuylkill Mnr Rd Pottsville, PA Phone: (800) Schuylkill Open MRI CBC # NPI/Ref # Tunnel Rd Ste 102 Pottsville, PA Phone: (570) Fax: (570) Snyder Old Trail Imaging LLC CBC # NPI/Ref # Susquehanna Vly Mall Dr Ste B Selinsgrove, PA Phone: (570) Fax: (570) Quantum Imaging and Therapeutic Associates CBC # NPI/Ref # Evangelical Outpatient Svcs 935 Rte 522 Selinsgrove, PA Phone: (570) Evangelical Selinsgrove Imaging Ctr 21 Susquehanna Vly Mall Dr Selinsgrove, PA Phone: (570) Union Quantum Imaging and Therapeutic Associates CBC # NPI/Ref # Evangelical Co Hosp 1 Hospital Dr Lewisburg, PA Phone: (570) Gary L Gasowski MD CBC # NPI/Ref # Charles St Ste 7 Hanover, PA Phone: (717) Fax: (717) OSS Health - Diagnostic Imaging CBC # NPI/Ref # Powder Mill Rd, PA Phone: (717) Fax: (717) Eisenhower Dr Hanover, PA Phone: (717) Fax: (717) Quantum Imaging and Therapeutic Associates CBC # NPI/Ref # D Lowther Rd Lewisberry, PA Phone: (717) Fax: (717) Apple Hill Radiation Therapy 25 Monument Rd Ste 94, PA Phone: (717) Fax: (717) Diagnostic Ctr at South Hanover 1404 Baltimore St Hanover, PA Phone: (717) Fax: (717) Dover Diagnostic Ctr 4020 Carlisle Rd Dover, PA Phone: (717) Fax: (717) Hanover Hospital 300 Highland Ave Hanover, PA Phone: (717) Hillside Imaging Ctr 250 Fame Ave Ste 104 Hanover, PA Phone: (717) Fax: (717) Holy Spirit Dillsburg Ctr 126 W Church St Dillsburg, PA Phone: (717) PinnacleHealth Imaging Dillsburg 1 Trinity Dr E Ste 120 Dillsburg, PA Phone: (717) Spring Grove Diagnostic Ctr 24 Roth Church Rd Spring Grove, PA Phone: (717) Fax: (717) Stonebridge Diagnostic Ctr Wolfe Rd New Freedom, PA Phone: (717) Fax: (717) Windsor Diagnostic Ctr 3065 Windsor Rd Red Lion, PA Phone: (717) Fax: (717) Women's Imaging at Apple Hill 35 Monument Rd Ste 201, PA Phone: (717) Hosp Imaging at Apple Hill 37 Monument Rd Ste 101, PA Phone: (717) Hospital 1001 S George St, PA Phone: (717) Fax: (717) Home Health Agency Adams Lutheran Home Care and Hospice CBC # NPI/Ref # W High St Gettysburg, PA Phone: (717) Fax: (717) Page 22

20 Home Health Agency Advance HomeHealth Care CBC # NPI/Ref # Penn Ave West Reading, PA Phone: (610) Fax: (610) Affilia Home Health CBC # NPI/Ref # Reading Hospital Home Care The Reading Hosp & Med Ctr 601 Spruce St Reading, PA Phone: (610) Fax: (610) BAYADA Home Health Care CBC # NPI/Ref # Meridian Blvd Phone: (800) Fax: (800) BAYADA Home Health Care CBC # 3A7770 NPI/Ref # Abington Rd Ste 330 Reading, PA Phone: (800) Fax: (800) Visiting Nurse Association CBC # NPI/Ref # hire Blvd Phone: (610) Fax: (610) Covenant Home Care CBC # NPI/Ref # Pottsville Pike Shoemakersville, PA Phone: (800) Fax: (570) Health Calls CBC # NPI/Ref # Broadcasting Rd Ste 202 Phone: (610) Fax: (610) Heartland Home Health Care and Hospice CBC # NPI/Ref # Park Plz Ste 105A Phone: (610) Fax: (610) Lutheran Home Care and Hospice CBC # NPI/Ref # Reed Ave Ste 102 Phone: (610) Fax: (610) Patient Care CBC # NPI/Ref # Ridgewood Rd Ste 210 Phone: (610) Fax: (610) Superior Health CBC # NPI/Ref # Windmill Rd Sinking Spring, PA Phone: (610) Fax: (610) Blair Home Nursing Agency and Visiting Nurse Association CBC # NPI/Ref # Chestnut Ave Altoona, PA Phone: (814) Fax: (814) Centre BAYADA Home Health Care CBC # NPI/Ref # E College Ave Ste 200 State College, PA Phone: (800) Fax: (800) Centre Homecare CBC # NPI/Ref # Coercial Blvd State College, PA Phone: (814) Fax: (814) Home Nursing Agency and Visiting Nurse Association CBC # NPI/Ref # Windmere Dr State College, PA Phone: (814) Fax: (814) Chester Southeastern Home Health Services CBC # NPI/Ref # Plaza Dr Downingtown, PA Phone: (610) Fax: (610) Columbia BAYADA Home Health Care CBC # NPI/Ref # Columbia Blvd Bloomsburg, PA Phone: (570) Berwick Home Health and Hospice CBC # NPI/Ref # Lows Rd Ste 102 Bloomsburg, PA Phone: (570) Fax: (570) BAYADA Home Health Care CBC # NPI/Ref # Louise Dr Ste 102 Mechanicsburg, PA Phone: (717) Celtic Healthcare of Carlisle CBC # NPI/Ref # Wilson St Ste 100 Carlisle, PA Phone: (717) Fax: (717) CMHC CBC # NPI/Ref # Village Dr Carlisle, PA Phone: (717) Fax: (717) Heartland Home Care CBC # NPI/Ref # Walnut Bottom Rd Ste 302 Carlisle, PA Phone: (717) Fax: (717) Holy Spirit Home Health Care CBC # NPI/Ref # Grandview Corp Pl Ste 309 Phone: (717) Fax: (717) Intrepid USA Healthcare Services CBC # NPI/Ref # Lemoyne Dr Ste 101 Lemoyne, PA Phone: (717) Fax: (717) Affilia Home Health CBC # NPI/Ref # N 3rd St Ste 300 Phone: (717) Fax: (717) BAYADA Home Health Care CBC # NPI/Ref # E Park Dr 1st Fl Harrisburg, PA Phone: (800) Fax: (800) Bello Nurses LLC CBC # NPI/Ref # N Mountain Rd Ste A Harrisburg, PA Phone: (717) Fax: (717) Home Remedy Skilled Nursing CBC # NPI/Ref # Jonestown Rd Ste 201 Phone: (717) Fax: (717) Home to Stay CBC # NPI/Ref # Allentown Blvd Harrisburg, PA Phone: (717) Fax: (717) Links2Care CBC # NPI/Ref # Queen Ave Ste 101 Phone: (717) Fax: (717) SUN Home Health Services CBC # NPI/Ref # Berrysburg Rd Ste 3 Millersburg, PA Phone: (717) Fax: (717) Visiting Nurse Association of Central Pennsylvania CBC # NPI/Ref # Market St Millersburg, PA Phone: (717) Fax: (717) Derry St Harrisburg, PA Phone: (717) Fax: (717) Franklin Counity Home Health Care CBC # NPI/Ref # Wayne Ave Ste 6 Phone: (717) Fax: (717) Home Nursing Agency and Visiting Nurse Association CBC # NPI/Ref # Suit Home Health 761 5th Ave Ste 2A Phone: (717) Fax: (717) Intrepid USA Healthcare Services CBC # NPI/Ref # th St Phone: (717) Fax: (717) Links2Care CBC # 3B7456 NPI/Ref # Cleveland Ave Phone: (717) Fax: (717) Lutheran Home Care and Hospice CBC # NPI/Ref # Luther Dr Phone: (717) Fax: (717) Affilia Home Health CBC # NPI/Ref # Olde Homestead Ln, PA Phone: (717) Fax: (717) Amedisys Home Health of CBC # NPI/Ref # New Holland Ave Ste 8101, PA Phone: (717) BAYADA Home Health Care CBC # 3B7770 NPI/Ref # Wm Penn Way Ste 106, PA Phone: (717) Gentiva Health Services CBC # NPI/Ref # Charter Ln Ste 106, PA Phone: (717) Fax: (717) Links2Care CBC # NPI/Ref # C Noll Dr, PA Phone: (717) Fax: (717) Intrepid USA Healthcare Services CBC # NPI/Ref # W Cherry St Palmyra, PA Phone: (717) Fax: (717) Amedisys Home Health of King of Prussia CBC # NPI/Ref # N Cedar Crest Blvd Ste 509 Allentown, PA Phone: (225) Arcadia Visiting Nurses LLC CBC # NPI/Ref # Tilghman St Ste 160 Allentown, PA Phone: (610) Fax: (610) At Home CBC # NPI/Ref # Washington St Schnecksville, PA Phone: (610) Fax: (267) BAYADA Home Health Care CBC # NPI/Ref # S Cedar Crest Blvd Phone: (800) Fax: (800) BAYADA Home Health Care CBC # 3A7722 NPI/Ref # Hamilton Blvd Ste 101 Phone: (800) Fax: (800) Extended Family Care CBC # NPI/Ref # S Cedar Crest Blvd Ste 102B Phone: (610) Fax: (610) Heartland Home Health Care and Hospice CBC # NPI/Ref # Marcon Blvd Ste 3700 Allentown, PA Phone: (610) Fax: (610) Interim Healthcare MidAtlantic CBC # NPI/Ref # Tilghman St Ste 205 Allentown, PA Phone: (610) Fax: (610) Valley Home Care CBC # NPI/Ref # S 12th St Phone: (610) Fax: (610) ANCILLARY PROVIDERS Page 23

21 Home Health Agency ANCILLARY PROVIDERS Loving Care Agency CBC # NPI/Ref # N Cedar Crest Blvd Allentown, PA Phone: (610) Fax: (610) Lutheran Home Care and Hospice CBC # NPI/Ref # Hausman Rd Ste 170 Allentown, PA Phone: (610) Fax: (610) Lutheran Home Care and Hospice CBC # 3A7133 NPI/Ref # S 12th St Fl 4 Phone: (610) Fax: (610) Patient Care CBC # NPI/Ref # Liberty Ln Ste 5 Allentown, PA Phone: (610) Fax: (610) Pediatric Services of America CBC # 3A7605 NPI/Ref # Rose Prof Bldg 1125 S Cedar Crest Blvd Ste 107 Phone: (610) Fax: (610) Providence Home Health Agency CBC # NPI/Ref # Main St Ste A Eaus, PA Phone: (610) Fax: (610) Revolutionary Home Health SVC LLC CBC # NPI/Ref # S Cedar Crest Blvd Ste 201-A Phone: (484) Fax: (866) Southeastern Home Health Services CBC # NPI/Ref # Sierra Cir Ste 205 Valley, PA Phone: (215) Fax: (215) Luzerne Lutheran Home Care and Hospice CBC # NPI/Ref # B N Church St Ste 403 Hazleton, PA Phone: (570) Fax: (570) Lycoming SUN Home Health Services CBC # NPI/Ref # Sycamore Rd Ste 2B Montoursville, PA Phone: (570) Fax: (570) Mifflin Home Nursing Agency and Visiting Nurse Association CBC # NPI/Ref # E Hale St Ste K Lewistown, PA Phone: (717) Fax: (717) SUN Home Health Services CBC # NPI/Ref # E Market St Lewistown, PA Phone: (717) Fax: (717) Montgomery Southeastern Home Health Services CBC # NPI/Ref # Bethlehem Pike Ste 202 Colmar, PA Phone: (215) Fax: (215) Geryville Pike Pennsburg, PA Phone: (267) Fax: (610) Sentry Pkwy Blue Bell, PA Phone: (267) Fax: (610) Montour Susquehanna Valley Home Health Care LLC CBC # NPI/Ref # Gotschal Rd Danville, PA Phone: (570) Fax: (570) BAYADA Home Health Care CBC # NPI/Ref # Highland Ave Ste 260 Phone: (610) Fax: (610) Easton Home Health and Hospice Services CBC # NPI/Ref # Emrick Blvd Ste 303 Bethlehem, PA Phone: (610) Fax: (610) Focus Home Care Services CBC # NPI/Ref # S 3rd St Ste 508 Easton, PA Phone: (484) Fax: (484) RX Home Care CBC # NPI/Ref # W Broad St Bethlehem, PA Phone: (610) Fax: (610) Slate Belt Visiting Nurses CBC # NPI/Ref # Blue Valley Dr Bangor, PA Phone: (800) Fax: (610) VNA of St Lukes Home Health and Hospice CBC # NPI/Ref # Valley Corp Ctr Valley Pkwy Phone: (610) Northumberland Family Home Medical CBC # NPI/Ref # S Oak St Mount Carmel, PA Phone: (570) Fax: (570) SUN Home Health Services CBC # NPI/Ref # E Independence St Shamokin, PA Phone: (570) Fax: (570) Duke St Northumberland, PA Phone: (570) Fax: (570) VNA Health System CBC # NPI/Ref # W Independence St Shamokin, PA Phone: (570) Fax: (570) Perry Safe Haven Skilled Services LLC CBC # NPI/Ref # W Main St New Bloomfield, PA Phone: (717) Fax: (717) SUN Home Health Services CBC # NPI/Ref # E Sunbury St PO Box 364 Millerstown, PA Phone: (717) Fax: (717) Schuylkill Blue Mountain Home Health Care CBC # NPI/Ref # W End Ave Ste A Pottsville, PA Phone: (570) Fax: (570) Kings Home Healthcare CBC # NPI/Ref # Peter St Ashland, PA Phone: (570) Fax: (570) Precision Home Healthcare CBC # NPI/Ref # S Centre St Ste 3B Pottsville, PA Phone: (570) Fax: (570) Schuylkill Health Home Health CBC # NPI/Ref # S Jackson St Pottsville, PA Phone: (570) Fax: (570) St Lukes Miners Memorial Home Care CBC # NPI/Ref # E Broad St Tamaqua, PA Phone: (570) Fax: (570) Snyder BAYADA Home Health Care CBC # NPI/Ref # W Snyder St Selinsgrove, PA Phone: (570) Union BAYADA Home Health Care CBC # NPI/Ref # Farley Cir Ste 103 Lewisburg, PA Phone: (570) SUN Home Health Services CBC # NPI/Ref # Reitz Blvd Ste 5 Lewisburg, PA Phone: (570) Fax: (570) BAYADA Home Health Care CBC # 3A8107 NPI/Ref # Queensgate Towne Ctr 2045 Springwood Rd, PA Phone: (717) Counity Home Nursing and Therapy Services CBC # NPI/Ref # Allegheny Ave Hanover, PA Phone: (717) Fax: (717) HEALTHSOUTH Therapy at Home CBC # NPI/Ref # Normandie Dr, PA Phone: (717) Fax: (717) Heartland Home Care CBC # NPI/Ref # A Concord Rd, PA Phone: (717) Fax: (717) Links2Care CBC # NPI/Ref # Theatre Ln, PA Phone: (717) Fax: (717) Lutheran Home Care and Hospice CBC # NPI/Ref # Mt Zion Rd, PA Phone: (717) Fax: (717) Memorial White Rose Home Health CBC # NPI/Ref # th Ave, PA Phone: (717) Fax: (717) OSS Health at Home CBC # NPI/Ref # Powder Mill Rd, PA Phone: (717) Fax: (717) Visiting Nurse Association Hanover & Spring Grove CBC # NPI/Ref # N Madison St Hanover, PA Phone: (717) Fax: (717) Adams Choice Healthcare CBC # 39HA36 NPI/Ref # S 6th St Mc Sherrystown, PA Phone: (717) Fax: (717) Dicks Homecare CBC # 39HA34 NPI/Ref # West St Gettysburg, PA Phone: (717) Fax: (717) Home Medical Equipment American DME LLC CBC # 39HB18 NPI/Ref # Penn Ave Phone: (610) Fax: (610) Medical Equipment CBC # 39HA07 NPI/Ref # B Wingco Ln Reading, PA Phone: (610) Fax: (610) A Wingco Ln Reading, PA Phone: (610) Fax: (610) The Counity Pharmacy 145 N 6th St Reading, PA Phone: (610) Fax: (610) Healthcare Evolution LLC CBC # 39HB85 NPI/Ref # Bellevue Ave Reading, PA Phone: (610) Fax: (610) Page 24

22 Home Medical Equipment InHome Oxygen and Medical Supplies CBC # 39HB16 NPI/Ref # Ave Reading, PA Phone: (610) Fax: (610) J and J Medical CBC # 39HA59 NPI/Ref # A W Main St Birdsboro, PA Phone: (610) Fax: (610) Lincare CBC # 3AHA05 NPI/Ref # Bern Rd Phone: (610) Fax: (610) Manny Esh Respiratory Care CBC # 39HA66 NPI/Ref # W Ave Shillington, PA Phone: (800) Fax: (610) Neighborcare At Home CBC # 39HA62 NPI/Ref # D MacArthur Rd Reading, PA Phone: (610) Fax: (610) Paramount Independent Living Aids CBC # 39HA97 NPI/Ref # Forgedale Rd Fleetwood, PA Phone: (610) Fax: (610) Superior Oxygen and Medical Equipment CBC # 39HB22 NPI/Ref # Penn Ave West Reading, PA Phone: (610) Fax: (610) Webb Medical Systems CBC # 3AHA45 NPI/Ref # A Parkside Ave Shillington, PA Phone: (610) Fax: (610) Blair Dicks Homecare CBC # 39HA34 NPI/Ref # Maple Ave Altoona, PA Phone: (800) Fax: (814) Cambria Walnut Medical Services CBC # 39HB28 NPI/Ref # Main St Johnstown, PA Phone: (814) Fax: (814) Carbon Keystone Medical Equipment CBC # 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39HA58 NPI/Ref # A Columbia Blvd Bloomsburg, PA Phone: (570) Fax: (570) Care Plus Oxygen CBC # 39HB04 NPI/Ref # th Ave Ste 6 Berwick, PA Phone: (570) Fax: (570) Columbia Ancillary Services CBC # 39HB32 NPI/Ref # State Rte 487 Bloomsburg, PA Phone: (570) Fax: (800) CPO2 CBC # 3EHA20 NPI/Ref # S Poplar St Berwick, PA Phone: (570) Fax: (570) American Home Medical Equipment Company LLC CBC # 39HB03 NPI/Ref # A Old Gettysburg Rd Phone: (717) Fax: (717) American HomePatient CBC # 3CHA39 NPI/Ref # Hartzdale Dr Phone: (717) Fax: (717) Apria Healthcare LLC CBC # 3BHA04 NPI/Ref # St Johns Church Rd Stes Phone: (717) Fax: (717) Care Plus Oxygen CBC # 39HB04 NPI/Ref # A State St Lemoyne, PA Phone: (717) Fax: (717) CPO2 CBC # 3CHA20 NPI/Ref # Westport Dr Ste 1600 Mechanicsburg, PA Phone: (717) Fax: (717) CressCare Medical CBC # 39HA51 NPI/Ref # Coerce Ave Carlisle, PA Phone: (717) Fax: (717) Family Home Medical CBC # 39HA72 NPI/Ref # Sprint Dr Carlisle, PA Phone: (717) Fax: (717) Lincare CBC # 3BHA87 NPI/Ref # Gettysburg Rd Phone: (866) Fax: (717) National Rehab Equipment CBC # 39HB11 NPI/Ref # N Spring Garden St Carlisle, PA Phone: (800) Fax: (800) Numotion CBC # 39HA60 NPI/Ref # Hartzdale Dr Ste 137 Phone: (717) Fax: (717) OSS Health CBC # NPI/Ref # Century Dr Mechanicsburg, PA Phone: (717) Respira CBC # 39HB65 NPI/Ref # Louise Dr Ste 103 Mechanicsburg, PA Phone: (717) Fax: (717) The Perfect Match Boutique CBC # 39HB00 NPI/Ref # Lowther Rd Phone: (717) Fax: (717) Apria Healthcare LLC CBC # 3BHA26 NPI/Ref # A Briarcrest Sq Hershey, PA Phone: (717) Fax: (717) Central Medical Equipment Co CBC # 39HA33 NPI/Ref # Sarhelm Rd Harrisburg, PA Phone: (717) Fax: (717) CressCare Medical CBC # 3AHA51 NPI/Ref # Linglestown Rd Phone: (717) Fax: (717) DJO LLC CBC # 39HB12 NPI/Ref # Powers Ave Phone: (717) Fax: (717) Dynamic Rehab Solutions LLC CBC # 39HB44 NPI/Ref # Lewis Rd Ste E1 Harrisburg, PA Phone: (717) Fax: (717) KCI USA CBC # 39HB15 NPI/Ref # Lewis Rd Ste E Harrisburg, PA Phone: (800) Fax: (888) Keystone Mobility CBC # 39HB41 NPI/Ref # Adams Dr Huelstown, PA Phone: (717) Fax: (717) Millersburg Pharmacy CBC # 39HA91 NPI/Ref # Market St Side Millersburg, PA Phone: (717) Fax: (717) Youngs Medical Equipment CBC # 39HA13 NPI/Ref # Flank Dr Ste 1400 Harrisburg, PA Phone: (717) Fax: (610) Franklin American HomePatient CBC # 3BHA39 NPI/Ref # Orchard Rd Waynesboro, PA Phone: (717) Fax: (717) Care Plus Oxygen CBC # 3DHB04 NPI/Ref # E Main St Waynesboro, PA Phone: (717) Fax: (717) CPO2 CBC # 3AHA20 NPI/Ref # Brim Blvd Ste 1 Phone: (717) Fax: (717) Dicks Homecare CBC # 39HA34 NPI/Ref # Gateway Ave Phone: (717) Fax: (717) Fulton Dicks Homecare CBC # 39HA34 NPI/Ref # Lincoln Way E Mc Connellsburg, PA Phone: (717) Fax: (717) Huntingdon Dicks Homecare CBC # 39HA34 NPI/Ref # Wm Penn Hwy Huntingdon, PA Phone: (814) Apria Healthcare LLC CBC # 39HA04 NPI/Ref # N Donnerville Rd Ste 2 Mountville, PA Phone: (717) Fax: (717) Bon-Cliff CBC # 39HB31 NPI/Ref # Scheller Rd New Providence, PA Phone: (717) Fax: (717) ANCILLARY PROVIDERS Page 25

23 Home Medical Equipment ANCILLARY PROVIDERS Central Medical Equipment Co CBC # 3BHA33 NPI/Ref # Arcadia Rd, PA Phone: (717) Fax: (717) Valley Respiratory Care CBC # 39HA41 NPI/Ref # Enterprise Ct East Petersburg, PA Phone: (717) Fax: (717) Life Solutions Plus CBC # 39HB63 NPI/Ref # Willow St Pike N Ste D Willow Street, PA Phone: (717) Fax: (717) Lincare CBC # 39HA05 NPI/Ref # Hempland Rd Unit 3, PA Phone: (717) Fax: (717) Respitech Medical CBC # 39HA55 NPI/Ref # Ranck Ave, PA Phone: (717) Fax: (717) UDS Home Medical Equipment LLC CBC # 39HB27 NPI/Ref # Olde Homestead Ln Manheim, PA Phone: (717) Fax: (717) W L Schneider Associates CBC # 39HB69 NPI/Ref # N Main St Manheim, PA Phone: (866) Fax: (215) Youngs Medical Equipment CBC # 39HA12 NPI/Ref # Granite Run Dr, PA Phone: (800) Fax: (610) Burmans Medical Supplies CBC # 39HB43 NPI/Ref # Rosemont Dr Myerstown, PA Phone: (800) Fax: (800) GSH Home Medical Care CBC # 39HA02 NPI/Ref # Schneider Dr, PA Phone: (717) Fax: (717) GSH Home Medical Care CBC # 3AHA02 NPI/Ref # E Main St Palmyra, PA Phone: (717) Fax: (717) American Home Medical Equipment and Services CBC # 39HB38 NPI/Ref # Hamilton Blvd Phone: (610) Fax: (610) Baird Medical Equipment CBC # 39HB19 NPI/Ref # Hamilton Blvd Allentown, PA Phone: (610) Fax: (610) Boas Surgical CBC # 39HB14 NPI/Ref # Hamilton Blvd Ste 220 Allentown, PA Phone: (484) Fax: (484) Hartzells Pharmacy and Home Health Care CBC # 39HA38 NPI/Ref # American St Catasauqua, PA Phone: (610) Fax: (610) Health Spectrum Pharmacy Services CBC # 39HA15 NPI/Ref # S Cedar Crest Blvd Phone: (610) Fax: (610) Mobility Unlimited CBC # 39HA30 NPI/Ref # N 12th St Allentown, PA Phone: (610) Fax: (610) Northeast Medical Sales CBC # 39HA79 NPI/Ref # Old Post Rd Ste 2 Coplay, PA Phone: (610) Fax: (610) RecoverCare LLC CBC # 39HB26 NPI/Ref # Marcon Blvd Ste 110 Allentown, PA Phone: (800) Fax: (800) Luzerne KCI USA CBC # 3AHB15 NPI/Ref # point Blvd Pittston, PA Phone: (800) Fax: (888) Luzerne Medical CBC # 39HB70 NPI/Ref # N Wyoming St Hazleton, PA Phone: (570) Fax: (570) Lycoming Susquehanna Ventures CBC # 39HA50 NPI/Ref # Grampian Blvd Ste 1F Williamsport, PA Phone: (570) Fax: (570) Mifflin American HomePatient CBC # 3BHA06 NPI/Ref # S Plaza Dr Lewistown, PA Phone: (717) Fax: (717) Dicks Homecare CBC # 39HA34 NPI/Ref # N Logan Blvd Burnham, PA Phone: (717) Fax: (717) Lewistown Pharmacy CBC # 39HB54 NPI/Ref # N Wayne St Lewistown, PA Phone: (717) Fax: (717) Montgomery Otto Bock Orthopedic Services LLC CBC # 39HB57 NPI/Ref # Bala Plz Ste IL E City Ave Bala Cynwyd, PA Phone: (800) Fax: (866) PR02 Respiratory Services CBC # 39HB86 NPI/Ref # rd Ave King Of Prussia, PA Phone: (610) Fax: (610) Royal Medical Supply CBC # 39HB58 NPI/Ref # E High St Pottstown, PA Phone: (610) Fax: (610) Montour 1st Choice Medical CBC # 39HA88 NPI/Ref # Bloom Rd Danville, PA Phone: (570) Fax: (570) Apria Healthcare LLC CBC # 3AHA26 NPI/Ref # Bloom Rd Danville, PA Phone: (570) Fax: (570) Advantage Orthopedics CBC # 39HB59 NPI/Ref # Bath Nazareth Hwy Nazareth, PA Phone: (484) Fax: (484) Allcare Medical CBC # NPI/Ref # S Coerce Way Phone: (800) Fax: (888) Apria Healthcare LLC CBC # 3CHA04 NPI/Ref # Ave C Ste 400 Phone: (610) Fax: (610) At Home Medical Equipment LLC CBC # 39HB47 NPI/Ref # Berger Dr Easton, PA Phone: (888) Fax: (888) Bell Apothecary CBC # 39HA31 NPI/Ref # Fairview Ave Easton, PA Phone: (610) Fax: (610) Boas Surgical CBC # 39HB14 NPI/Ref # High Point Blvd Ste 200 Phone: (484) Fax: (484) Helping Hands Medical Supply LLC CBC # 39HB36 NPI/Ref # Linden St Phone: (610) Fax: (610) Hoveround Corporation CBC # 39HB02 NPI/Ref # Winside Dr Phone: (800) Fax: (800) Lincare CBC # 39HA87 NPI/Ref # Highland Ave Unit E Phone: (610) Fax: (610) Newhard Pharmacy CBC # 39HB46 NPI/Ref # Main St, PA Phone: (610) Fax: (610) Royal Homestar LLC CBC # NPI/Ref # Emrick Blvd Bethlehem, PA Phone: (610) Fax: (888) Slate Belt Medical Equipment and Supplies CBC # 39HA75 NPI/Ref # Blue Valley Dr Bangor, PA Phone: (610) Fax: (610) Walgreens Infusion Services CBC # 39HA14 NPI/Ref # Adler Pl Bldg A Ste 120 Bethlehem, PA Phone: (610) Fax: (610) Webb Medical Systems CBC # 39HA45 NPI/Ref # Main St, PA Phone: (610) Fax: (610) Wellcare Home Mobility CBC # 39HB21 NPI/Ref # B Blue Valley Dr Pen Argyl, PA Phone: (610) Fax: (610) Youngs Medical Equipment CBC # 39HA10 NPI/Ref # Emrick Blvd Bethlehem, PA Phone: (610) Fax: (610) Northumberland Assist Home Care CBC # 39HB17 NPI/Ref # W Independence St Shamokin, PA Phone: (570) Fax: (570) Millersburg Pharmacy CBC # 39HA91 NPI/Ref # Dal-Hern Pharmacy 4372 State Rte 147 Herndon, PA Phone: (570) Fax: (570) Susquehanna Valley Mobility Services CBC # 39HB09 NPI/Ref # Dance Hall Rd Milton, PA Phone: (570) Fax: (570) Perry Bloomfield Pharmacy CBC # 39HB53 NPI/Ref # W Main St New Bloomfield, PA Phone: (717) Fax: (717) Schuylkill American HomePatient CBC # 39HA39 NPI/Ref # S Claude A Lord Blvd Rte 61 Pottsville, PA Phone: (570) Fax: (570) American Surgical Supply CBC # 39HB45 NPI/Ref # Pottsville St Clair Hwy Ste 2 Pottsville, PA Phone: (570) Fax: (570) Apria Healthcare LLC CBC # 39HA26 NPI/Ref # Sharp Mountain Plz Gordon Nagle Trl Ste 9-10 Pottsville, PA Phone: (570) Fax: (570) Care Plus Oxygen CBC # 3EHB04 NPI/Ref # Ste 110 Branch Twp 2880 Pottsville Minersville Hwy Minersville, PA Phone: (570) Fax: (570) Page 26

24 Hospice Concept Medical CBC # 39HA23 NPI/Ref # th & Chestnut Sts Ashland, PA Phone: (570) Fax: (570) CPO2 CBC # 3BHA20 NPI/Ref # Pottsville Minersville Hwy Ste 100 Minersville, PA Phone: (570) Fax: (570) Manny Esh Respiratory Care CBC # 39HA66 NPI/Ref # S James St Schuylkill Haven, PA Phone: (570) Fax: (570) Standard Drug CBC # 39HA85 NPI/Ref # S Hancock St McAdoo, PA Phone: (570) Fax: (570) Union CPO2 CBC # 39HA20 NPI/Ref # E Chestnut St Mifflinburg, PA Phone: (570) Fax: (570) Homecare Products CBC # 39HA29 NPI/Ref # Westbranch Hwy Lewisburg, PA Phone: (570) Fax: (570) Hub's Home Oxygen and Medical Supplies CBC # 39HB08 NPI/Ref # JPM Rd Ste D Lewisburg, PA Phone: (570) Fax: (570) All Medical and Equipment Supplies CBC # 39HB68 NPI/Ref # E Broadway Red Lion, PA Phone: (717) Fax: (717) American HomePatient CBC # 3AHA06 NPI/Ref # Leader Hghts Rd, PA Phone: (717) Fax: (717) Care Plus Oxygen CBC # 3FHB04 NPI/Ref # th Ave Ste 119-A, PA Phone: (717) Fax: (717) Central Medical Equipment Co CBC # 3AHA33 NPI/Ref # Greenbriar Rd, PA Phone: (717) Fax: (717) Counity Care of Harrisburg LLC CBC # 39HB64 NPI/Ref # town Rd Lewisberry, PA Phone: (717) Fax: (717) Foot Solutions of CBC # 39HB20 NPI/Ref # Whiteford Rd, PA Phone: (717) Fax: (717) Life Changes Boutique CBC # 39HB49 NPI/Ref # St Hanover, PA Phone: (717) Fax: (717) Lincare CBC # 3AHA87 NPI/Ref # Eisenhower Dr Hanover, PA Phone: (717) Fax: (717) Lincare CBC # 3CHA87 NPI/Ref # Freedom Way Ste 100, PA Phone: (717) Fax: (717) OSS Health CBC # NPI/Ref # Powder Mill Rd, PA Phone: (717) Fax: (717) OSS Health CBC # NPI/Ref # th Ave, PA Phone: (717) Fax: (717) OSS Health CBC # NPI/Ref # Eisenhower Dr Hanover, PA Phone: (717) Fax: (717) Health Boutique for Women LLC CBC # 39HA96 NPI/Ref # Leader Heights Rd, PA Phone: (717) Fax: (717) Home Medical Equipment - Mail Order 180 Medical CBC # 39HB52 NPI/Ref # Phone: (877) Fax: (888) ActivStyle CBC # NPI/Ref # Phone: (800) Fax: (800) ApniCure CBC # NPI/Ref # Phone: (650) Fax: (650) Arriva Medical LLC CBC # 39HB76 NPI/Ref # Phone: (800) Fax: (954) Better Living Now CBC # 39HB79 NPI/Ref # Phone: (631) Fax: (631) Biomet Spine and Bone Healing Technologies CBC # NPI/Ref # Phone: (800) Fax: (973) Bioventus LLC CBC # NPI/Ref # Phone: (800) Fax: (866) Byram Healthcare s CBC # 39HB48 NPI/Ref # Phone: (877) Fax: (914) CCS Medical CBC # NPI/Ref # Phone: (800) Fax: (800) Edgepark Medical Supplies CBC # NPI/Ref # Phone: (800) Fax: (330) Electromed CBC # NPI/Ref # Phone: (952) Fax: (952) Empi CBC # 39HB80 NPI/Ref # Phone: (800) Fax: (800) Home Care Delivered CBC # NPI/Ref # Phone: (800) Fax: (888) Insulet Corporation CBC # 39HB61 NPI/Ref # Phone: (978) Fax: (978) KCI USA CBC # 3BHB15 NPI/Ref # Phone: (800) Fax: (888) Liberator Medical Supply CBC # 39HB66 NPI/Ref # Phone: (800) Fax: (800) Medical Solutions Supplier CBC # 39HB62 NPI/Ref # Phone: (800) Fax: (800) Medline Healthcare Company CBC # NPI/Ref # Phone: (800) Fax: (847) National Biological Corporation CBC # NPI/Ref # Phone: (800) Fax: (216) NeighborCare At Home CBC # 3AHA62 NPI/Ref # Phone: (610) Fax: (610) Numotion CBC # 39HB40 NPI/Ref # Phone: (610) Fax: (610) Orthofix CBC # 39HB78 NPI/Ref # Phone: (800) Fax: (214) Respir Tech CBC # NPI/Ref # Phone: (651) Fax: (866) Tactile Systems Technology CBC # NPI/Ref # Phone: (612) Fax: (866) Verus Healthcare CBC # 39HB75 NPI/Ref # Phone: (800) Fax: (800) Zoll Lifecor Corporation CBC # NPI/Ref # Phone: (412) Fax: (866) Adams Lutheran Home Care and Hospice CBC # NPI/Ref # W High St Gettysburg, PA Phone: (717) Fax: (717) Hospice Visiting Nurse Association CBC # NPI/Ref # hire Blvd Phone: (610) Fax: (610) Covenant Home Care - Hospice CBC # NPI/Ref # Pottsville Pike Shoemakersville, PA Phone: (800) Fax: (570) Heartland Hospice Services CBC # NPI/Ref # Park Plz Ste 105-A Phone: (610) Fax: (610) Lutheran Home Care and Hospice CBC # 3B1527 NPI/Ref # Reed Ave Ste 102 Phone: (610) Fax: (610) Blair Home Nursing Agency & Visiting Nurse Association Hospice CBC # NPI/Ref # Chestnut Ave Altoona, PA Phone: (814) Centre Centre Hospice CBC # NPI/Ref # Coerical Blvd State College, PA Phone: (814) Fax: (814) Home Nursing Agency & Visiting Nurse Association Hospice CBC # NPI/Ref # Windmere Dr State College, PA Phone: (814) Fax: (814) Columbia Berwick Home Health and Hospice CBC # NPI/Ref # Lows Rd Ste 102 Bloomsburg, PA Phone: (570) Fax: (570) Celtic Hospice and Palliative Care of Carlisle CBC # NPI/Ref # Century Dr Ste 201 Mechanicsburg, PA Phone: (717) Fax: (877) Compassionate Care Hospice CBC # NPI/Ref # Cedar Cliff Dr Ste 100 Phone: (717) Fax: (717) Grane Hospice Care CBC # NPI/Ref # Lemoyne Dr Ste 201 Lemoyne, PA Phone: (717) Heartland Hospice Services CBC # NPI/Ref # Walnut Bottom Rd Ste 302 Carlisle, PA Phone: (717) Fax: (717) Odyssey HealthCare of Harrisburg CBC # NPI/Ref # Trindle Rd Ste 204 Phone: (717) Fax: (717) ANCILLARY PROVIDERS Page 27

25 Hospice ANCILLARY PROVIDERS AseraCare Hospice CBC # NPI/Ref # S Houcks Rd Ste 101 Phone: (717) Fax: (717) Crossings Hospice CBC # NPI/Ref # Market St Millersburg, PA Phone: (717) Fax: (717) Derry St Harrisburg, PA Phone: (717) Fax: (717) Homeland Hospice CBC # NPI/Ref # Vartan Way Ste 115 Phone: (717) Fax: (717) Hospice of Central Pennsylvania CBC # NPI/Ref # Linglestown Rd Phone: (717) Fax: (717) Legacy Hospice and Palliative Care CBC # NPI/Ref # Jonestown Rd Ste 201 Phone: (717) Fax: (717) SUN Home Health Services CBC # NPI/Ref # Berrysburg Rd Ste 3 Millersburg, PA Phone: (717) Fax: (717) Franklin Home Nursing Agency & Visiting Nurse Association Hospice CBC # NPI/Ref # Suit Home Health 761 5th Ave Ste 2A Phone: (717) Fax: (717) Lutheran Home Care and Hospice CBC # NPI/Ref # Luther Dr Phone: (717) Fax: (717) AseraCare Hospice CBC # NPI/Ref # Primrose Ln Ste 101 Mountville, PA Phone: (717) Fax: (717) Hospice & Counity Care CBC # NPI/Ref # Old Harrisburg Pike Mount Joy, PA Phone: (717) Fax: (717) Good Dr, PA Phone: (717) Fax: (717) Masonic Village Hospice CBC # NPI/Ref # Masonic Dr Elizabethtown, PA Phone: (717) Fax: (717) Good Samaritan Hospital Hospice (The) CBC # NPI/Ref # th & Walnut Sts, PA Phone: (717) Fax: (717) Arcadia Hospice LLC CBC # NPI/Ref # Tilghman St Ste 160 Allentown, PA Phone: (610) Fax: (610) AseraCare Hospice CBC # NPI/Ref # Hamilton Blvd Ste 103 Allentown, PA Phone: (610) Fax: (610) At Home Hospice Care CBC # NPI/Ref # Washington St Schnecksville, PA Phone: (610) Fax: (267) Heartland Hospice Services CBC # NPI/Ref # Marcon Blvd Ste 3700 Allentown, PA Phone: (610) Fax: (610) Valley Hospice CBC # NPI/Ref # S 12th St Phone: (610) Fax: (610) Lutheran Home Care and Hospice CBC # 3A1527 NPI/Ref # Hausman Rd Ste 170 Allentown, PA Phone: (610) Fax: (610) Lycoming SUN Home Health Services CBC # NPI/Ref # Sycamore Rd Ste 2B Montoursville, PA Phone: (570) Fax: (570) Mifflin Home Nursing Agency & Visiting Nurse Association Hospice CBC # NPI/Ref # E Hale St Ste K Lewistown, PA Phone: (717) Fax: (717) SUN Home Health Services CBC # NPI/Ref # E Market St Lewistown, PA Phone: (717) Fax: (717) Easton Home Health and Hospice Services CBC # NPI/Ref # Emrick Blvd Ste 303 Bethlehem, PA Phone: (610) Fax: (610) VNA of St Lukes Home Health and Hospice CBC # NPI/Ref # Valley Corp Ctr Valley Pkwy Phone: (610) Northumberland Family Home Medical Hospice CBC # NPI/Ref # S Oak St Mount Carmel, PA Phone: (570) Fax: (570) SUN Home Health Services CBC # NPI/Ref # E Independence St Shamokin, PA Phone: (570) Fax: (570) Duke St Northumberland, PA Phone: (570) Fax: (570) VNA Health System Crossings Hospice CBC # NPI/Ref # W Independence St Shamokin, PA Phone: (570) Fax: (570) Perry SUN Home Health Services CBC # NPI/Ref # E Sunbury St PO Box 364 Millerstown, PA Phone: (717) Fax: (717) Union Evangelical Counity Hospital Hospice CBC # NPI/Ref # Hospital Dr Lewisburg, PA Phone: (570) Fax: (570) SUN Home Health Services CBC # NPI/Ref # Reitz Blvd Ste 5 Lewisburg, PA Phone: (570) Fax: (570) AseraCare Hospice CBC # NPI/Ref # Bowman Rd, PA Phone: (717) Fax: (717) Heartland Hospice Services CBC # NPI/Ref # C Concord Rd, PA Phone: (717) Fax: (717) Hospice & Counity Care CBC # NPI/Ref # St Charles Way Ste 200, PA Phone: (888) Memorial White Rose Hospice CBC # NPI/Ref # th Ave, PA Phone: (717) Fax: (717) VNA of Hanover and Spring Grove Hospice Program CBC # NPI/Ref # N Madison St Hanover, PA Phone: (717) Fax: (717) Infusion Therapy Adams Choice Critical Care CBC # 39HI17 NPI/Ref # S 6th St Mc Sherrystown, PA Phone: (717) Fax: (717) Healthcare Evolution LLC CBC # 39HI30 NPI/Ref # Bellevue Ave Reading, PA Phone: (610) Fax: (610) Coram Alternate Site Services CBC # 3AHI02 NPI/Ref # St Johns Church Rd Stes Phone: (717) Fax: (717) Coram Alternate Site Services CBC # 3AHI02 NPI/Ref # Briarcrest Sq Hershey, PA Phone: (717) Fax: (717) Critical Care Systems CBC # 39HI11 NPI/Ref # Flank Dr Ste 600 Harrisburg, PA Phone: (717) Fax: (717) Coram Alternate Site Services CBC # 3AHI02 NPI/Ref # N Donnerville Rd Ste 1 Mountville, PA Phone: (717) Fax: (717) Horizon Healthcare Services CBC # 39HI06 NPI/Ref # New Holland Ave, PA Phone: (717) Fax: (717) Burmans Specialty Pharmacy CBC # 39HI27 NPI/Ref # Rosemont Dr Myerstown, PA Phone: (800) Fax: (800) Health Spectrum Pharmacy Services CBC # 39HI03 NPI/Ref # S Cedar Crest Blvd Ste 105 Phone: (610) Fax: (610) SH Pharmacy and Infusion Services CBC # 39HI09 NPI/Ref # W Chew St Ste 201 Allentown, PA Phone: (610) Fax: (610) Montour Coram Alternate Site Services CBC # 3AHI02 NPI/Ref # Bloom Rd Danville, PA Phone: (570) Fax: (570) Page 28

26 Prosthetics & Orthotics Snyder Coram Alternate Site Services CBC # 3AHI02 NPI/Ref # Ave C Ste 400 Phone: (610) Fax: (610) Homestar RX and Infusion Services CBC # 39HI15 NPI/Ref # S Coerce Way Ste 200 Phone: (484) Fax: (610) Walgreens Infusion Services CBC # 39HI04 NPI/Ref # Adler Pl Bldg A Ste 120 Bethlehem, PA Phone: (610) Fax: (610) Schuylkill Concept Medical CBC # 39HI16 NPI/Ref # th & Chestnut Sts Ashland, PA Phone: (570) Fax: (570) Coram Alternate Site Services CBC # 3AHI02 NPI/Ref # Sharp Mountain Plz Gordon Nagle Trl Stes 9-10 Pottsville, PA Phone: (570) Fax: (570) DeBalkos Standard Drug CBC # 39HI25 NPI/Ref # S Hancock St McAdoo, PA Phone: (570) Fax: (570) Coram Alternate Site Services CBC # 3AHI02 NPI/Ref # Interchange Pl Ste C, PA Phone: (717) Fax: (717) Home Solutions CBC # 39HI26 NPI/Ref # C Concord Rd, PA Phone: (888) Physical Rehab - Outpatient Schuylkill Schuylkill Rehabilitation CBC # NPI/Ref # Schuylkill Medical Plz Pottsville, PA Phone: (570) Fax: (570) Prosthetics & Orthotics Boas Surgical CBC # 3AHA32 NPI/Ref # hire Blvd Ste 900 Phone: (610) Fax: (610) Hanger Prosthetics and Orthotics CBC # 39HA86 NPI/Ref # New Holland Rd Shillington, PA Phone: (610) Fax: (610) NexStep CBC # 39HB05 NPI/Ref # Quarry Dr Ste E63 West Lawn, PA Phone: (610) Fax: (610) Prosthetic Orthotic Service CBC # 39HB30 NPI/Ref # N 9th St Reading, PA Phone: (610) Fax: (877) Blair Allegheny Orthotics and Prosthetics CBC # 39HA94 NPI/Ref # th Ave Altoona, PA Phone: (814) Fax: (814) Centre Lindquist Family Foot Care CBC # 39HB25 NPI/Ref # E College Ave Pleasant Gap, PA Phone: (814) Fax: (814) Chester Ability Prosthetics and Orthotics CBC # 3AHB07 NPI/Ref # W Lincoln Hwy Exton, PA Phone: (610) Fax: (610) Ability Prosthetics and Orthotics CBC # 3BHB07 NPI/Ref # Technology Pkwy 200 Mechanicsburg, PA Phone: (717) Fax: (717) Cardin and Miller Physical Therapy CBC # 39HB33 NPI/Ref # Pkwy Mechanicsburg, PA Phone: (717) Fax: (717) E Pomfret St Ste 1 Carlisle, PA Phone: (717) Fax: (717) for Advanced Orthotics & Prosthetics (The) CBC # 39HA25 NPI/Ref # Century Dr Mechanicsburg, PA Phone: (800) Fax: (717) Hanger/Teufel Prosthetics and Orthotics CBC # 3AHA24 NPI/Ref # Trindle Rd Phone: (717) Fax: (717) National Rehab Equipment CBC # 39HB01 NPI/Ref # N Spring Garden St Carlisle, PA Phone: (800) Fax: (800) for Advanced Orthotics & Prosthetics (The) CBC # 39HA25 NPI/Ref # Devonshire Rd Ste 100 Phone: (717) Fax: (717) Children's Brace CBC # 39HA95 NPI/Ref # Governor Rd Ste 8 Hershey, PA Phone: (717) Fax: (717) DJO LLC CBC # 39HB13 NPI/Ref # Powers Ave Phone: (717) Fax: (717) Hanger/Teufel Prosthetics and Orthotics CBC # 3BHA24 NPI/Ref # E Park Dr Harrisburg, PA Phone: (717) Fax: (717) Lawall at Hershey CBC # 39HA98 NPI/Ref # Hope Dr EC 182 Hershey, PA Phone: (717) Fax: (717) Lawall at Hershey CBC # 3AHA98 NPI/Ref # S Arlington Ave Phone: (717) Fax: (717) Randy Stevens Family Footcare CBC # 39HB51 NPI/Ref # E Park Dr Ste 100 Harrisburg, PA Phone: (717) Fax: (717) Franklin Hanger/Teufel Prosthetics and Orthotics CBC # 3CHA24 NPI/Ref # th Ave Ste D Phone: (717) Fax: (717) Superior Medical Equipment Group CBC # NPI/Ref # N 7th St Ste 101 Phone: (717) Benchmark Orthotics and Prosthetics CBC # 39HB23 NPI/Ref # Lincoln Hwy E Ste 4, PA Phone: (717) Fax: (717) Boas Surgical CBC # 3CHA32 NPI/Ref # Lemon St East Petersburg, PA Phone: (717) Fax: (717) for Advanced Orthotics & Prosthetics (The) CBC # 39HA25 NPI/Ref # W James St Ste 101, PA Phone: (717) Fax: (717) Hanger Prosthetics and Orthotics CBC # 3AHA86 NPI/Ref # Harrisburg Pike Ste 308, PA Phone: (717) Fax: (717) Hanger/Teufel Prosthetics and Orthotics CBC # 39HA24 NPI/Ref # N Hanover St Elizabethtown, PA Phone: (717) Fax: (717) Prosthetic Orthotic Service CBC # 39HB30 NPI/Ref # Ave, PA Phone: (610) Valley Prosthetics and Orthotics CBC # 39HB39 NPI/Ref # S Cedar Crest Blvd Ste 105 Phone: (610) Fax: (610) Montgomery Harry J Lawall and Son CBC # 39HA61 NPI/Ref # Sunny Brook Village 800 Heritage Dr Ste 803 Pottstown, PA Phone: (610) Fax: (610) Synergy Orthopedics LLC CBC # 39HB55 NPI/Ref # Jolly Rd Plymouth Meeting, PA Phone: (610) Fax: (610) Montour Hanger Prosthetics and Orthotics East CBC # 3AHA93 NPI/Ref # E Market St Danville, PA Phone: (570) Fax: (570) Allied OP CBC # 39HA63 NPI/Ref # Brodhead Rd Ste 106 Phone: (610) Fax: (610) Boas Surgical CBC # 39HA32 NPI/Ref # High Point Blvd Ste 200 Phone: (484) Fax: (484) Boas Surgical CBC # 3BHA32 NPI/Ref # High Point Blvd Ste 200 Phone: (484) Fax: (484) Cocco Enterprises CBC # NPI/Ref # Easton Ave Bethlehem, PA Phone: (484) Foot Solutions Easton CBC # 39HB60 NPI/Ref # Nazareth Rd Ste D Easton, PA Phone: (610) Fax: (610) Hanger Prosthetics and Orthotics East CBC # 39HA93 NPI/Ref # Bath Pike Ste 102 Phone: (610) Fax: (610) Northumberland Central PA Prosthetics and Orthotics CBC # 39HA89 NPI/Ref # S Market St Elysburg, PA Phone: (570) Fax: (570) Snyder Susquehanna Valley Prosthetics and Orthotics CBC # 39HA76 NPI/Ref # N Old Trl Ste A Shamokin Dam, PA Phone: (570) Fax: (570) ANCILLARY PROVIDERS Page 29

27 Prosthetics & Orthotics ANCILLARY PROVIDERS Ability Prosthetics and Orthotics CBC # 39HB07 NPI/Ref # Fame Ave Hanover, PA Phone: (717) Fax: (717) Ability Prosthetics and Orthotics CBC # 3CHB07 NPI/Ref # S George St, PA Phone: (717) Fax: (717) for Advanced Orthotics & Prosthetics (The) CBC # 39HA25 NPI/Ref # D Eisenhower Dr Hanover, PA Phone: (800) Fax: (717) Rodney Rd, PA Phone: (717) Fax: (717) Zielke Orthotics and Prosthetics CBC # 39HA57 NPI/Ref # Rodney Rd, PA Phone: (717) Fax: (717) Radiation Therapy Franklin Chambersburg Health Services Cancer Treatment CBC # NPI/Ref # N 7th St Phone: (717) Fax: (717) Renal Dialysis FMC Dialysis Services of Kutztown CBC # NPI/Ref # Constitution Blvd Kutztown, PA Phone: (610) Fax: (610) Pennsylvania Dialysis Clinic of Reading CBC # NPI/Ref # Spring St Phone: (610) Fax: (610) Reading Dialysis CBC # NPI/Ref # Dengler St Reading, PA Phone: (610) Fax: (610) Centre Bio-Medical Applications of State College CBC # NPI/Ref # S Atherton St Ste 7 State College, PA Phone: (814) Fax: (814) Bio-Medical Applications of County CBC # NPI/Ref # E High St Carlisle, PA Phone: (717) Fax: (717) DCA of Camp Hill LLC CBC # NPI/Ref # S 32nd St Ste 19 Phone: (717) Fax: (717) Dialysis Corporation of America - Mechanicsburg CBC # NPI/Ref # S Filbert St Mechanicsburg, PA Phone: (717) Fax: (717) Dialysis Services of Pennsylvania - Carlisle CBC # NPI/Ref # Noble Blvd Ste 103 Carlisle, PA Phone: (717) Fax: (717) Fresenius Medical Care Camp Hill CBC # NPI/Ref # Grandview Ave Phone: (717) Fax: (717) Liberty Dialysis - Camp Hill CBC # NPI/Ref # N 12th St Lemoyne, PA Phone: (717) Fax: (717) Bio-Medical Applications of Harrisburg CBC # NPI/Ref # Union Deposit Rd Union Ct Harrisburg, PA Phone: (717) Fax: (717) FMC Dialysis Services of the Capital Area CBC # NPI/Ref # Linglestown Rd Phone: (717) Fax: (717) Renal Care Group Harrisburg CBC # NPI/Ref # N 3rd St Ste 101 Phone: (717) Fax: (717) Renal Care Group Millersburg CBC # NPI/Ref # Evelyn Dr Millersburg, PA Phone: (717) Fax: (717) Franklin Dialysis Services of Pennsylvania - Chambersburg CBC # NPI/Ref # Park 5th Ave Prof Ctr 765 5th Ave Ste A Phone: (717) Fax: (717) FMC Dialysis Services of Waynesboro CBC # NPI/Ref # Vista Dr Waynesboro, PA Phone: (717) Fresenius Medical Care Chambersburg CBC # NPI/Ref # Norland Ave Ste 104 Phone: (717) Fax: (717) FMC Dialysis Services of County CBC # NPI/Ref # Rte Londonderry Sq Shopping Ctr Palmyra, PA Phone: (717) Fax: (717) Bio-Medical Applications of Allentown CBC # NPI/Ref # Hamilton Blvd Phone: (610) Fax: (610) Bio-Medical Applications of Fullerton CBC # NPI/Ref # Mickley Rd Whitehall, PA Phone: (610) Fax: (610) FMC NA of South Allentown CBC # NPI/Ref # Mitchell Ave Phone: (610) Bio-Medical Applications of Bethlehem CBC # NPI/Ref # City Line Rd Ste 200 Phone: (610) Fax: (610) Bio-Medical Applications of Easton CBC # NPI/Ref # Northwood Ave Easton, PA Phone: (610) Fax: (610) Kidney Treatment of SlateBelt CBC # NPI/Ref # E West St Wind Gap, PA Phone: (610) Fax: (610) Perry Fresenius Medical Care New Bloomfield CBC # NPI/Ref # S Carlisle St New Bloomfield, PA Phone: (717) Fax: (717) Schuylkill Bio-Medical Applications of Pottsville CBC # NPI/Ref # Industrial Park Rd Pottsville, PA Phone: (570) Fax: (570) FMC of Tamaqua CBC # NPI/Ref # E Broad St Tamaqua, PA Phone: (570) Dialysis Corporation of America - CBC # NPI/Ref # Kenneth Rd, PA Phone: (717) Fax: (717) Urgent Care Advanced Urgent Care of Sinking Spring CBC # NPI/Ref # W Penn Ave Sinking Spring, PA Phone: (610) Fax: (610) Concentra Urgent Care CBC # NPI/Ref # Pottsville Pike Reading, PA Phone: (866) Fax: (610) Patient First - Urgent Care CBC # NPI/Ref # Papermill Rd Phone: (484) Fax: (484) Premier Iediate Medical Care LLC Urgent Care CBC # NPI/Ref # W Ben Franklin Hwy Ste 114 Douglassville, PA Phone: (610) Fax: (610) Priority Care - Urgent Care CBC # NPI/Ref # Perkiomen Ave Reading, PA Phone: (610) Fax: (610) Bucks Patient First - Urgent Care CBC # NPI/Ref # Patient First Festerville 75 E Street Rd Feasterville Trevos, PA Phone: (267) Fax: (267) Centre Advanced Urgent Care CBC # NPI/Ref # E College Ave State College, PA Phone: (814) Fax: (814) Dr Pauls Clinic - Urgent Care CBC # NPI/Ref # N Atherton St Ste 100 State College, PA Phone: (814) Fax: (814) MedExpress Urgent Care - State College CBC # NPI/Ref # N Atherton St Ste B State College, PA Phone: (814) Fax: (814) Chester Premier Iediate Medical Care LLC Urgent Care CBC # NPI/Ref # Eagleview Blvd Exton, PA Phone: (610) Fax: (610) All Better Care - Urgent CBC # NPI/Ref # Walnut Bottom Rd Carlisle, PA Phone: (717) Fax: (717) Carlisle Pike Mechanicsburg, PA Phone: (717) Fax: (717) Concentra Urgent Care CBC # NPI/Ref # Ritter Rd Mechanicsburg, PA Phone: (866) Fax: (717) Patient First - Urgent Care CBC # NPI/Ref # S Sporting Hill Rd Mechanicsburg, PA Phone: (717) Fax: (717) Page 30

28 Urgent Care Concentra Urgent Care CBC # NPI/Ref # Union Deposit Rd Harrisburg, PA Phone: (866) Fax: (717) Patient First - Urgent Care CBC # NPI/Ref # Jonestown Rd Ste 105 Harrisburg, PA Phone: (717) Fax: (717) Franklin MedExpress Urgent Care - State College CBC # NPI/Ref # Lincoln Way E Ste 101 Phone: (717) Fax: (717) Concentra Urgent Care CBC # NPI/Ref # Butler Ave, PA Phone: (866) Fax: (717) LGH Urgent Care - Ephrata CBC # NPI/Ref # E Main St Ephrata, PA Phone: (717) Fax: (717) LGH Urgent Care - Rohrerstown CBC # NPI/Ref # Spring Valley Rd, PA Phone: (717) Fax: (717) MedExpress Urgent Care - State College CBC # NPI/Ref # Rohrerstown Rd, PA Phone: (717) Fax: (717) Patient First - Urgent Care CBC # NPI/Ref # Patient First 1625 Oregon Pike, PA Phone: (717) Fax: (717) MedExpress Urgent Care - State College CBC # NPI/Ref # W Crestview Dr, PA Phone: (717) Fax: (717) East Penn Medical - Urgent Care CBC # NPI/Ref # Chestnut St Eaus, PA Phone: (610) Fax: (610) Saucon Valley Medical - Urgent Care CBC # NPI/Ref # Saucon Creek Rd Valley, PA Phone: (610) Fax: (610) SCHC Pediatric Associates LLC-Urgent Care CBC # NPI/Ref # Cetronia Rd Ste 100 Allentown, PA Phone: (215) Fax: (215) St Lukes Urgent Care - West End CBC # NPI/Ref # Centronia Rd Ste 103 Allentown, PA Phone: (484) Fax: (484) Montgomery Patient First - Urgent Care CBC # NPI/Ref # Patient First East Norriton 400 E Germantown Pk East Norriton, PA Phone: (610) Fax: (610) Patient First Montgomeryville 713 Bethlehem Pike Montgomeryville, PA Phone: (267) Fax: (267) Patient First Pottstown 119 Shoemaker Rd Pottstown, PA Phone: (610) Fax: (610) Premier Iediate Medical Care LLC Urgent Care CBC # NPI/Ref # W Ridge Pike Limerick, PA Phone: (610) Fax: (610) Cresson Blvd Oaks, PA Phone: (610) Fax: (610) Northstar Urgent Care CBC # NPI/Ref # Nazareth Pike Nazareth, PA Phone: (610) Patient First - Urgent Care CBC # NPI/Ref # Patient First Bethlehem 2310 Schoenersville Rd Phone: (484) Fax: (484) Patient First Easton 2450 Butler St Easton, PA Phone: (610) Fax: (610) Premier Iediate Medical Care LLC Urgent Care CBC # NPI/Ref # S Main St Hellertown, PA Phone: (610) Fax: (610) Priority Care - Urgent Care CBC # NPI/Ref # Male Rd Wind Gap, PA Phone: (610) Fax: (610) St Lukes Urgent Care - Wind Gap CBC # NPI/Ref # E Moorestown Rd Wind Gap, PA Phone: (484) Fax: (484) St Lukes Urgent Care - North CBC # NPI/Ref # Brodhead Rd Phone: (484) Fax: (484) Snyder MedExpress Urgent Care - State College CBC # NPI/Ref # MedExpress Urgent Care - Selinsgrove 1597 N Susquehanna Trl Selinsgrove, PA Phone: (570) Fax: (570) Concentra Urgent Care CBC # NPI/Ref # Pennsylvania Ave, PA Phone: (866) Fax: (717) Loucks Rd Unit D, PA Phone: (866) Fax: (717) MedExpress Urgent Care - State College CBC # NPI/Ref # Baltimore St Hanover, PA Phone: (717) Fax: (717) Loucks Rd, PA Phone: (717) Patient First - Urgent Care CBC # NPI/Ref # E Market St, PA Phone: (717) Fax: (717) ANCILLARY PROVIDERS Page 31

29 LABORATORIES The following section lists Quest Diagnostics Patient Service s, Health Network Laboratories (HNL) Patient Service s, and other in-network laboratories. SecureChoice SM membership cards indicate the laboratory arrangements for the Member s PCP. If the SecureChoice SM membership card has a laboratory indicator of DL for Quest Diagnostics, specimens for all routine outpatient laboratory services must either be drawn in the participating provider s office and sent to Quest Diagnostics or be drawn at a Quest Diagnostics Patient Service. SecureChoice SM Members who have a PCP that is part of the Valley Physician Hospital Organization (LVPHO) must obtain laboratory services through HNL for such Members, specimens for all routine outpatient laboratory services must either be drawn in the participating provider s office and sent to HNL, or be drawn at an HNL draw center. SecureChoice SM Members should contact their PCP, or SecureChoice SM Customer Service, for information concerning their PCP s laboratory arrangements. 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 33

30 LABORATORIES DRAW CENTERS QUEST DIAGNOSTICS The following section lists Quest Diagnostics orporated Draw s. SecureChoice SM Member ID cards indicate the laboratory arrangement for the Member s PCP. If the Member ID card has a laboratory indicator of DL for Quest Diagnostics, specimens for all routine outpatient laboratory services must be either drawn in the participating provider s office and sent to Quest Diagnostics or be drawn at a Quest Diagnostics Patient Service. Important Notes Members may now schedule an appointment at a Quest Diagnostics Patient Service through the Quest Diagnostics website at questdiagnostics.com/appointment or by calling the interactive voice response system at Zip code entry ensures scheduling at the nearest Patient Service. 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 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 35

31 Quest Diagnostics 1323 Rte 100 Barto, PA Phone: (610) Fax: (610) Mon: 7:00 am-1:00 pm Tues: 7:00 am-1:00 pm Wed: 7:00 am-1:00 pm Thurs: 7:00 am-1:00 pm Fri: 7:00 am-1:00 pm 2001 State Hill Rd Ste 130 Phone: (610) Fax: (610) Mon: 6:30 am-11:30 am; 12:30 pm-5:00 pm Tues: 6:30 am-11:30 am; 12:30 pm-5:00 pm Wed: 6:30 am-11:30 am; 12:30 pm-5:00 pm Thurs: 6:30 am-11:30 am; 12:30 pm-5:00 pm Fri: 6:30 am-11:30 am; 12:30 pm-5:00 pm Sat: 7:00 am-12:00 pm 3050 N 5th St Hwy Reading, PA Phone: (610) Fax: (610) Mon: 7:00 am-11:00 am; Tues: 7:00 am-11:00 am; Wed: 7:00 am-11:00 am; Thurs: 7:00 am-11:00 am; Fri: 7:00 am-11:00 am; Sat: 7:00 am-12:00 pm 321 N Furnace St Birdsboro, PA Phone: (610) Fax: (610) :00 pm-1:00 pm 12:00 pm-1:00 pm 12:00 pm-1:00 pm 12:00 pm-1:00 pm 12:00 pm-1:00 pm 400-B S 4th St Hamburg, PA Phone: (610) Fax: (610) Mon: 6:30 am-12:00 pm Tues: 7:00 am-12:00 pm Wed: 6:30 am-12:00 pm Thurs: 7:00 am-12:00 pm Fri: 6:30 am-12:00 pm Sat: 7:00 am-10:00 pm 4400 Perkiomen Ave Reading, PA Phone: (610) Fax: (610) Mon: 6:30 am-12:15 pm; 1:00 pm-2:30 pm Tues: 6:30 am-12:15 pm; 1:00 pm-2:30 pm Wed: 6:30 am-12:15 pm; 1:00 pm-2:30 pm Thurs: 6:30 am-12:15 pm; 1:00 pm-2:30 pm Fri: 6:30 am-12:15 pm; 1:00 pm-2:30 pm Sat: 7:00 am-11:30 am 520 E Ave Shillington, PA Phone: (610) Fax: (610) Mon: 6:30 am-12:00 pm; 12:45 pm-2:00 pm Tues: 6:30 am-12:00 pm; 12:45 pm-2:00 pm Wed: 6:30 am-12:00 pm; 12:45 pm-2:00 pm Thurs: 6:30 am-12:00 pm; 12:45 pm-2:00 pm Fri: 6:30 am-12:00 pm; 12:45 pm-2:00 pm Sat: 7:00 am-11:30 am 525 Penn St Reading, PA Phone: (610) Fax: (610) Mon: 7:00 am-1:30 pm Tues: 7:00 am-1:30 pm Wed: 7:00 am-1:30 pm Thurs: 7:00 am-1:30 pm Fri: 7:00 am-1:30 pm Quality Medical Labs Schoolside Plz Rte 61 & Wall St Leesport, PA Phone: (610) Mon: 8:00 am-5:00 pm Tues: 8:00 am-5:00 pm Wed: 8:00 am-5:00 pm Thurs: 8:00 am-5:00 pm Fri: 8:00 am-5:00 pm St Joseph Health Ctr 5400 Perkiomen Ave Reading, PA Phone: (973) Mon: 8:00 am-5:00 pm Tues: 8:00 am-5:00 pm Wed: 8:00 am-5:00 pm Thurs: 8:00 am-5:00 pm Fri: 8:00 am-5:00 pm St Joseph Hosp Imaging Ctr 3935 Perkiomen Ave Reading, PA Phone: (610) Mon: 8:00 am-5:00 pm Tues: 8:00 am-5:00 pm Wed: 8:00 am-5:00 pm Thurs: 8:00 am-5:00 pm Fri: 8:00 am-5:00 pm St Joseph Hospital Lab 2500 Bernville Rd Reading, PA Phone: (610) Mon: 8:00 am-5:00 pm Tues: 8:00 am-5:00 pm Wed: 8:00 am-5:00 pm Thurs: 8:00 am-5:00 pm Fri: 8:00 am-5:00 pm St Joseph Quality Med Lab 1800 N 12th St Reading, PA Phone: (610) Mon: 8:00 am-5:00 pm Tues: 8:00 am-5:00 pm Wed: 8:00 am-5:00 pm Thurs: 8:00 am-5:00 pm Fri: 8:00 am-5:00 pm Bucks Quest Diagnostics 130 Almshouse Rd Richboro, PA Phone: (215) Fax: (215) Mon: 7:00 am-4:00 pm Tues: 7:00 am-4:00 pm Wed: 7:00 am-4:00 pm Thurs: 7:00 am-4:00 pm Fri: 7:00 am-4:00 pm 14 Memorial Dr Ste B Doylestown, PA Phone: (215) Fax: (215) Mon: 8:00 am-12:00 pm; 12:45 pm-2:00 pm Tues: 8:00 am-12:00 pm; 12:45 pm-2:00 pm Wed: 8:00 am-12:00 pm; 12:45 pm-2:00 pm Thurs: 8:00 am-12:00 pm; 12:45 pm-2:00 pm Fri: 8:00 am-12:00 pm; 12:45 pm-2:00 pm 153 Levittown Pkwy Ste 5A Levittown, PA Phone: (215) Fax: (215) Woodbourne Rd Levittown, PA Phone: (215) Fax: (215) Mon: 7:30 am-12:00 pm; 12:45 pm-3:30 pm Tues: 7:30 am-12:00 pm; 12:45 pm-3:30 pm Wed: 7:30 am-12:00 pm; 12:45 pm-3:30 pm Thurs: 7:30 am-12:00 pm; 12:45 pm-3:30 pm Fri: 7:30 am-12:00 pm; 12:45 pm-3:30 pm 1700 Horizon Dr Ste 205 Chalfont, PA Phone: (215) Fax: (215) Mon: 6:30 am-11:30 am; Tues: 6:30 am-11:30 am; Wed: 6:30 am-11:30 am; Thurs: 6:30 am-11:30 am; Fri: 6:30 am-11:30 am; Sat: 8:00 am-12:00 pm 210 E Street Rd 3rd Fl Ste 3D Feasterville, PA Phone: (215) Fax: (215) Mon: 6:30 am-11:30 am; Tues: 6:30 am-11:30 am; Wed: 6:30 am-11:30 am; Thurs: 6:30 am-11:30 am; Fri: 6:30 am-11:30 am; 2118 S Eagle Rd Store 14 Newtown, PA Phone: (215) Fax: (215) N West End Blvd Quakertown, PA Phone: (215) Fax: (215) Mon: 7:00 am-3:30 pm Tues: 7:00 am-3:30 pm Wed: 7:00 am-3:30 pm Thurs: 7:00 am-3:30 pm Fri: 7:00 am-3:30 pm Sat: 8:00 am-12:00 pm 252 W Swamp Rd Doylestown, PA Phone: (215) Fax: (215) Mon: 6:30 am-3:30 pm Tues: 6:30 am-3:30 pm Wed: 6:30 am-3:30 pm Thurs: 6:30 am-3:30 pm Fri: 6:30 am-3:30 pm Sat: 8:00 am-12:00 pm 300 Farm Ln Ste 300 Doylestown, PA Phone: (215) Fax: (215) :15 pm-1:00 pm 12:15 pm-1:00 pm 12:15 pm-1:00 pm 12:15 pm-1:00 pm 12:15 pm-1:00 pm 333 N Oxford Vly Rd Ste 203 Fairless Hills, PA Phone: (215) Fax: (215) Mon: 7:30 am-11:30 am; Tues: 7:30 am-11:30 am; Wed: 7:30 am-11:30 am; Thurs: 7:30 am-11:30 am; Fri: 7:30 am-11:30 am; 406 Floral Vale Blvd Yardley, PA Phone: (215) Fax: (215) Constitution Ave Perkasie, PA Phone: (215) Middletown Blvd Ste C-11 Langhorne, PA Phone: (215) Fax: (215) Mon: 7:00 am-12:00 pm; 12:45 pm-6:00 pm Tues: 7:00 am-12:00 pm; 12:45 pm-6:00 pm Wed: 7:00 am-12:00 pm; 12:45 pm-6:00 pm Thurs: 7:00 am-12:00 pm; 12:45 pm-6:00 pm Fri: 7:00 am-12:00 pm; 12:45 pm-6:00 pm Sat: 8:00 am-12:00 pm 634 Easton Rd Warrington, PA Phone: (215) Fax: (215) Bristol Park Shopping Ctr 200 Coerce Cir Bristol, PA Phone: (215) Fax: (215) Mon: 7:00 am-11:00 am; 11:45 am-3:30 pm Tues: 7:00 am-11:00 am; 11:45 am-3:30 pm Wed: 7:00 am-11:00 am; 11:45 am-3:30 pm Thurs: 7:00 am-11:00 am; 11:45 am-3:30 pm Fri: 7:00 am-11:00 am; 11:45 am-3:30 pm Sat: 7:00 am-11:00 am Buckingham Green Shopping Ctr 4920 Rd Unit 2 Holicong, PA Phone: (215) Fax: (215) QUEST PATIENT SERVICE CENTERS Page 37

32 Centre QUEST PATIENT SERVICE CENTERS Centre Quest Diagnostics Mount Nittany Med Ctr 1800 E Park Ave State College, PA Phone: (814) Mon: 7:00 am-7:00 pm Tues: 7:00 am-7:00 pm Wed: 7:00 am-7:00 pm Thurs: 7:00 am-7:00 pm Fri: 7:00 am-7:00 pm Sat: 7:00 am-12:00 pm Chester Quest Diagnostics 1011 Baltimore Pike Ste 112 West Grove, PA Phone: (610) Fax: (610) Mon: 6:00 am-4:00 pm Tues: 6:00 am-4:00 pm Wed: 6:00 am-4:00 pm Thurs: 6:00 am-4:00 pm Fri: 6:00 am-4:00 pm Sat: 8:00 am-12:00 pm 1235 Horseshoe Pike Downingtown, PA Phone: (610) Fax: (610) Mon: 6:30 am-11:30 am; 12:00 pm-2:00 pm Tues: 6:30 am-11:30 am; 12:00 pm-2:00 pm Wed: 6:30 am-11:30 am; 12:00 pm-2:00 pm Thurs: 6:30 am-11:30 am; 12:00 pm-2:00 pm Fri: 6:30 am-11:30 am; 12:00 pm-2:00 pm 15 Industrial Blvd Ste A-101 Paoli, PA Phone: (610) Fax: (610) Mon: 6:30 am-11:45 am; 12:30 pm-3:00 pm Tues: 6:30 am-11:45 am; 12:30 pm-3:00 pm Wed: 6:30 am-11:45 am; 12:30 pm-3:00 pm Thurs: 6:30 am-11:45 am; 12:30 pm-3:00 pm Fri: 6:30 am-11:45 am; 12:30 pm-3:00 pm Sat: 8:00 am-12:00 pm 1502 W Chester Pike West Chester, PA Phone: (610) Fax: (610) W Ave Devon, PA Phone: (610) Fax: (610) Mon: 7:00 am-11:15 am; Tues: 7:00 am-11:15 am; Wed: 7:00 am-11:15 am; Thurs: 7:00 am-11:15 am; Fri: 7:00 am-11:15 am; 250 W Ave Paoli, PA Phone: (610) Fax: (610) Mon: 7:00 am-11:15 am; 12:00 pm-3:30 pm Tues: 7:00 am-11:15 am; 12:00 pm-3:30 pm Wed: 7:00 am-11:15 am; 12:00 pm-3:30 pm Thurs: 7:00 am-11:15 am; 12:00 pm-3:30 pm Fri: 7:00 am-11:15 am; 12:00 pm-3:30 pm 308 E Ave Downingtown, PA Phone: (610) Fax: (610) Mon: 6:30 am-3:00 pm Tues: 6:30 am-3:00 pm Wed: 6:30 am-3:00 pm Thurs: 6:30 am-3:00 pm Fri: 6:30 am-3:00 pm Sat: 7:00 am-11:00 am 309 Ave Frazer, PA Phone: (610) Fax: (610) E Lincoln Hwy Thorndale, PA Phone: (610) Fax: (610) Mon: 6:30 am-4:00 pm Tues: 6:30 am-4:00 pm Wed: 6:30 am-4:00 pm Thurs: 6:30 am-4:00 pm Fri: 6:30 am-4:00 pm Sat: 8:00 am-12:00 pm 402 McFarlan Rd Kennett Square, PA Phone: (610) Fax: (610) Mon: 6:30 am-3:30 pm Tues: 6:30 am-3:30 pm Wed: 6:30 am-3:30 pm Thurs: 6:30 am-3:30 pm Fri: 6:30 am-3:30 pm Sat: 7:30 am-11:30 am 600 E Marshall St West Chester, PA Phone: (610) Fax: (610) Mon: 6:30 am-3:00 pm Tues: 6:30 am-3:00 pm Wed: 6:30 am-3:00 pm Thurs: 6:30 am-3:00 pm Fri: 6:30 am-3:00 pm Sat: 8:00 am-12:00 pm 80 W Welsh Pool Rd Ste 102 Exton, PA Phone: (610) Fax: (610) Mon: 6:30 am-11:30 am; 12:00 pm-3:30 pm Tues: 6:30 am-11:30 am; 12:00 pm-3:30 pm Wed: 6:30 am-11:30 am; 12:00 pm-3:30 pm Thurs: 6:30 am-11:30 am; 12:00 pm-3:30 pm Fri: 6:30 am-11:30 am; 12:00 pm-3:30 pm Sat: 8:00 am-12:00 pm Oaks Corporate Ctr 450 Cresson Blvd Ste 3 Phoenixville, PA Phone: (610) Fax: (610) Mon: 6:30 am-11:30 am; Tues: 6:30 am-11:30 am; Wed: 6:30 am-11:30 am; Thurs: 6:30 am-11:30 am; Fri: 6:30 am-11:30 am; Phoenixville Plz 700 Nutt Rd Unit 735 Phoenixville, PA Phone: (610) Fax: (610) Mon: 6:30 am-2:30 pm Tues: 6:30 am-2:30 pm Wed: 6:30 am-2:30 pm Thurs: 6:30 am-2:30 pm Fri: 6:30 am-2:30 pm Sat: 8:00 am-11:30 am Phoneixville Hospital 140 Nutt Rd Phoenixville, PA Phone: (610) Mon: 8:00 am-4:00 pm Tues: 8:00 am-4:00 pm Wed: 8:00 am-4:00 pm Thurs: 8:00 am-4:00 pm Fri: 8:00 am-4:00 pm School House Rd & Rte Onix Dr Kennett Square, PA Phone: (610) Fax: (610) Mon: 6:30 am-12:30 pm; 1:00 pm-2:30 pm Tues: 6:30 am-12:30 pm; 1:00 pm-2:30 pm Wed: 6:30 am-12:30 pm; 1:00 pm-2:30 pm Thurs: 6:30 am-12:30 pm; 1:00 pm-2:30 pm Fri: 6:30 am-12:30 pm; 1:00 pm-2:30 pm St Joseph Health Network 45 S Pine St Elverson, PA Phone: (610) Mon: 7:00 am-9:00 pm Sat: 8:00 am-4:00 pm Sun: 10:00 am-4:00 pm Whiteland Towne S/C 183 W Lincoln Hwy Unit 820-A Exton, PA Phone: (610) Fax: (610) Mon: 7:00 am-11:15 am; Tues: 7:00 am-11:15 am; Wed: 7:00 am-11:15 am; Thurs: 7:00 am-11:15 am; Fri: 7:00 am-11:15 am; Columbia Quest Diagnostics Berwick Hospital 701 E 16th St Berwick, PA Phone: (570) Mon: 7:00 am-7:00 pm Tues: 7:00 am-7:00 pm Wed: 7:00 am-7:00 pm Thurs: 7:00 am-7:00 pm Fri: 7:00 am-7:00 pm Sat: 7:00 am-11:30 am Quest Diagnostics 3401 Hartzdale Dr Phone: (717) Fax: (717) Mon: 7:00 am-4:00 pm Tues: 7:00 am-4:00 pm Wed: 7:00 am-4:00 pm Thurs: 7:00 am-4:00 pm Fri: 7:00 am-4:00 pm Sat: 8:00 am-11:30 am 40 Brookwood Ave Carlisle, PA Phone: (717) Fax: (717) Mon: 6:00 am-3:30 pm Tues: 6:00 am-3:30 pm Wed: 6:00 am-3:30 pm Thurs: 6:00 am-3:30 pm Fri: 6:00 am-3:30 pm Sat: 7:00 am-11:00 am Holy Spirit Hospital N 21st St Phone: (717) Mon: 7:00 am-5:00 pm Tues: 7:00 am-5:00 pm Wed: 7:00 am-7:00 pm Thurs: 7:00 am-5:00 pm Fri: 7:00 am-5:00 pm Sat: 8:00 am-12:00 pm PinnacleHealth Hospitals Seidle Outpatient Ctr 120 S Filbert St Mechanicsburg, PA Phone: (717) Mon: 8:00 am-5:00 pm Tues: 8:00 am-5:00 pm Wed: 8:00 am-5:00 pm Thurs: 8:00 am-5:00 pm Fri: 8:00 am-5:00 pm Quest Diagnostics S 17th St Phone: (717) Fax: (717) Mon: 8:00 am-12:00 pm; 12:45 pm-4:30 pm Tues: 8:00 am-12:00 pm; 12:45 pm-4:30 pm Wed: 8:00 am-12:00 pm; 12:45 pm-4:30 pm Thurs: 8:00 am-12:00 pm; 12:45 pm-4:30 pm Fri: 8:00 am-12:00 pm; 12:45 pm-4:30 pm 2021 Linglestown Rd Phone: (717) Fax: (717) Mon: 7:30 am-12:30 pm; 1:15 pm-3:30 pm Tues: 7:30 am-12:30 pm; 1:15 pm-3:30 pm Wed: 7:30 am-12:30 pm; 1:15 pm-3:30 pm Thurs: 7:30 am-12:30 pm; 1:15 pm-3:30 pm Fri: 7:30 am-12:30 pm; 1:15 pm-3:30 pm 4824 Londonderry Rd Phone: (717) Fax: (717) Mon: 7:00 am-12:00 pm; 12:30 pm-3:00 pm Tues: 7:00 am-12:00 pm; 12:30 pm-3:00 pm Wed: 7:00 am-12:00 pm; 12:30 pm-3:00 pm Thurs: 7:00 am-12:00 pm; 12:30 pm-3:00 pm Fri: 7:00 am-12:00 pm; 12:30 pm-3:00 pm Sat: 7:00 am-11:00 am PinnacleHealth Hospitals Counity Gen Osteopathic Hosp 4300 Londonderry Rd Phone: (717) Mon: 8:00 am-5:00 pm Tues: 8:00 am-5:00 pm Wed: 8:00 am-5:00 pm Thurs: 8:00 am-5:00 pm Fri: 8:00 am-5:00 pm PinnacleHealth Hospitals Polyclinic Medical Ctr 2601 N 3rd St Phone: (717) Mon: 8:00 am-5:00 pm Tues: 8:00 am-5:00 pm Wed: 8:00 am-5:00 pm Thurs: 8:00 am-5:00 pm Fri: 8:00 am-5:00 pm Franklin Quest Diagnostics 144 S 8th St Phone: (717) Fax: (717) Mon: 7:00 am-3:00 pm Tues: 7:00 am-3:00 pm Wed: 7:00 am-3:00 pm Thurs: 7:00 am-3:00 pm Fri: 7:00 am-3:00 pm Sat: 7:00 am-11:00 am Page 38

33 Franklin Waynesboro Mall 626 E Main St Waynesboro, PA Phone: (717) Fax: (717) Mon: 7:00 am-12:00 pm Tues: 7:00 am-12:00 pm Wed: 7:00 am-12:00 pm Thurs: 7:00 am-12:00 pm Fri: 7:00 am-12:00 pm Sat: 7:00 am-10:00 am Fulton Quest Diagnostics Fulton County Medical Ctr 214 Peach Orchard Rd Mc Connellsburg, PA Phone: (717) Mon: 7:00 am-7:00 pm Tues: 7:00 am-7:00 pm Wed: 7:00 am-7:00 pm Thurs: 7:00 am-7:00 pm Fri: 7:00 am-7:00 pm Sat: 7:00 am-11:00 am Quest Diagnostics 112 N Reading Rd Ephrata, PA Phone: (717) Fax: (717) :00 pm-2:30 pm 12:00 pm-2:30 pm 12:00 pm-2:30 pm 12:00 pm-2:30 pm 12:00 pm-2:30 pm Sat: 7:00 am-11:00 am 215 Granite Run Dr, PA Phone: (717) Fax: (717) Mon: 7:00 am-12:00 pm; 12:45 pm-3:00 pm Tues: 7:00 am-12:00 pm; 12:45 pm-3:00 pm Wed: 7:00 am-12:00 pm; 12:45 pm-3:00 pm Thurs: 7:00 am-12:00 pm; 12:45 pm-3:00 pm Fri: 7:00 am-12:00 pm; 12:45 pm-3:00 pm Sat: 7:00 am-11:00 am Ephrata Medical Ctr Rothsville Medical Ctr 1810 Rothsville Rd Lititz, PA Phone: (717) Mon: 8:00 am-5:00 pm Tues: 8:00 am-5:00 pm Wed: 8:00 am-5:00 pm Thurs: 8:00 am-5:00 pm Fri: 8:00 am-5:00 pm Heart of Reg Med Ctr 1500 Highlands Dr Lititz, PA Phone: (717) Mon: 8:00 am-5:00 pm Tues: 8:00 am-5:00 pm Wed: 8:00 am-5:00 pm Thurs: 8:00 am-5:00 pm Fri: 8:00 am-5:00 pm Regional Med Ctr 250 College Ave, PA Phone: (717) Mon: 7:00 am-5:00 pm Tues: 7:00 am-5:00 pm Wed: 7:00 am-5:00 pm Thurs: 7:00 am-5:00 pm Fri: 7:00 am-5:00 pm Sat: 7:00 am-12:00 pm Quest Diagnostics 725 E Lincoln Ave Myerstown, PA Phone: (717) Fax: (717) Mon: 7:00 am-12:00 pm; 12:30 pm-1:00 pm Tues: 7:00 am-12:00 pm; 12:30 pm-1:00 pm Wed: 7:00 am-12:00 pm; 12:30 pm-1:00 pm Thurs: 7:00 am-12:00 pm; 12:30 pm-1:00 pm Fri: 7:00 am-12:00 pm; 12:30 pm-1:00 pm Sat: 7:00 am-11:00 am Rte 422 W, PA Phone: (717) Fax: (717) Sat: 7:00 am-11:00 am Quest Diagnostics 111 E Harrison St Eaus, PA Phone: (610) Fax: (610) Mon: 7:30 am-4:00 pm Tues: 7:30 am-4:00 pm Wed: 7:30 am-4:00 pm Thurs: 7:30 am-4:00 pm Fri: 7:30 am-4:00 pm 1251 S Cedar Crest Blvd Phone: (610) Fax: (610) Mon: 7:30 am-1:30 pm Tues: 7:30 am-1:30 pm Wed: 7:30 am-1:30 pm Thurs: 7:30 am-1:30 pm Fri: 7:30 am-1:30 pm Sat: 7:30 am-11:30 am 1608 W Allen St Allentown, PA Phone: (610) Fax: (610) Mon: 6:30 am-3:30 pm Tues: 6:30 am-3:30 pm Wed: 6:30 am-3:30 pm Thurs: 6:30 am-3:30 pm Fri: 6:30 am-3:30 pm Sat: 7:00 am-11:00 am 4662 Broadway Rd Unit A-13 Allentown, PA Phone: (610) Fax: (610) Mon: 7:00 am-11:45 am; 12:30 pm-3:30 pm Tues: 7:00 am-11:45 am; 12:30 pm-3:30 pm Wed: 7:00 am-11:45 am; 12:30 pm-3:30 pm Thurs: 7:00 am-11:45 am; 12:30 pm-3:30 pm Fri: 7:00 am-11:45 am; 12:30 pm-3:30 pm 7096 Decatur St New Tripoli, PA Phone: (610) Fax: (610) Mon: 7:00 am-12:00 pm; 12:30 pm-3:30 pm Tues: 7:00 am-12:00 pm; 12:30 pm-3:30 pm Wed: 7:00 am-12:00 pm; 12:30 pm-3:30 pm Thurs: 7:00 am-12:00 pm; 12:30 pm-3:30 pm Fri: 7:00 am-12:00 pm; 12:30 pm-3:30 pm Caramoor Vlg 6465 Village Ln Macungie, PA Phone: (610) Fax: (610) Mon: 7:00 am-1:00 pm Tues: 7:00 am-1:00 pm Wed: 7:00 am-1:00 pm Thurs: 7:00 am-1:00 pm Fri: 7:00 am-1:00 pm Fairmount Vlg Shopping Ctr 7001 Rte 309 Coopersburg, PA Phone: (484) Fax: (484) Mon: 6:30 am-12:30 pm Tues: 6:30 am-12:30 pm Wed: 6:30 am-12:30 pm Thurs: 6:30 am-12:30 pm Fri: 6:30 am-12:30 pm Sacred Heart Hospital 421 Chew St Allentown, PA Phone: (610) Mon: 7:00 am-6:00 pm Tues: 7:00 am-6:00 pm Wed: 7:00 am-6:00 pm Thurs: 7:00 am-6:00 pm Fri: 7:00 am-6:00 pm Sat: 8:00 am-12:00 pm Luzerne Quest Diagnostics 20 N Laurel St Hazleton, PA Phone: (570) Mon: 6:30 am-11:30 am; Tues: 6:30 am-11:30 am; Wed: 6:30 am-11:30 am; Thurs: 6:30 am-11:30 am; Fri: 6:30 am-11:30 am; Sat: 7:00 am-11:00 am Pennant Laboratories 425 Tioga Ave Kingston, PA Phone: (570) Mon: Varies-Varies Tues: Varies-Varies Wed: Varies-Varies Thurs: Varies-Varies Fri: Varies-Varies Monroe Quest Diagnostics Intermountain Medical Group Rtes 940 & 155 Blakeslee, PA Phone: (570) Mon: Varies-Varies Tues: Varies-Varies Wed: Varies-Varies Thurs: Varies-Varies Fri: Varies-Varies Pleasant Valley Plz 1656 Rte 209 Brodheadsville, PA Phone: (570) Fax: (570) Pocono Plz 314 Lincoln Ave East Stroudsburg, PA Phone: (570) Fax: (570) Mon: 7:00 am-3:00 pm Tues: 7:00 am-3:00 pm Wed: 7:00 am-3:00 pm Thurs: 7:00 am-3:00 pm Fri: 7:00 am-3:00 pm Sat: 8:00 am-12:00 pm Montgomery Quest Diagnostics 1000 Easton Rd Ste 270 Wyncote, PA Phone: (215) Fax: (215) E Philadelphia Ave Gilbertsville, PA Phone: (610) Fax: (610) Mon: 6:00 am-2:30 pm Tues: 6:00 am-2:30 pm Wed: 6:00 am-2:30 pm Thurs: 6:00 am-2:30 pm Fri: 6:00 am-2:30 pm Sat: 7:00 am-11:30 am 1050 S Broad St Lansdale, PA Phone: (215) Fax: (215) Mon: 6:30 am-11:15 am; Tues: 6:30 am-11:15 am; Wed: 6:30 am-11:15 am; Thurs: 6:30 am-11:15 am; Fri: 6:30 am-11:15 am; Sat: 8:00 am-11:30 am 1107 Bethlehem Pike Ste 103 Flourtown, PA Phone: (215) Fax: (215) Mon: 7:30 am-11:30 am; 12:15 pm-4:00 pm Tues: 7:30 am-11:30 am; 12:15 pm-4:00 pm Wed: 7:30 am-11:30 am; 12:15 pm-4:00 pm Thurs: 7:30 am-11:30 am; 12:15 pm-4:00 pm Fri: 7:30 am-11:30 am; 12:15 pm-4:00 pm 130 W Main St Trappe, PA Phone: (610) Fax: (610) Mon: 7:00 am-11:15 am; Tues: 7:00 am-11:15 am; Wed: 7:00 am-11:15 am; Thurs: 7:00 am-11:15 am; Fri: 7:00 am-11:15 am; Sat: 8:00 am-11:30 am 1419 Old Rd Abington, PA Phone: (215) Fax: (215) Mon: 6:30 am-4:30 pm Wed: 6:30 am-4:30 pm Thurs: 6:30 am-4:30 pm Fri: 6:30 am-4:30 pm Sat: 8:00 am-12:00 pm 1437 DeKalb St Norristown, PA Phone: (610) Fax: (610) Mon: 7:30 am-11:30 am; 12:15 pm-4:00 pm Tues: 7:30 am-11:30 am; 12:15 pm-4:00 pm Wed: 7:30 am-11:30 am; 12:15 pm-4:00 pm Thurs: 7:30 am-11:30 am; 12:15 pm-4:00 pm Fri: 7:30 am-11:30 am; 12:15 pm-4:00 pm 1569 Medical Dr Pottstown, PA Phone: (610) Fax: (610) Mon: 6:00 am-4:00 pm Tues: 6:00 am-4:00 pm Wed: 6:00 am-4:00 pm Thurs: 6:00 am-4:00 pm Fri: 6:00 am-4:00 pm Sat: 8:00 am-11:30 am QUEST PATIENT SERVICE CENTERS Page 39

34 Montgomery QUEST PATIENT SERVICE CENTERS 170 N Henderson Rd Ste 204 King of Prussia, PA Phone: (610) Fax: (610) Lakeside Dr Ste 230 Horsham, PA Phone: (215) Fax: (215) Mon: 7:00 am-3:30 pm Tues: 7:00 am-3:30 pm Wed: 7:00 am-3:30 pm Thurs: 7:00 am-3:30 pm Fri: 7:00 am-3:30 pm Sat: 8:00 am-12:00 pm 2131 N Broad St Lansdale, PA Phone: (215) Fax: (215) A Shoemaker Rd Ste 169 Pottstown, PA Phone: (610) Fax: (610) Mon: 6:30 am-11:30 am; Tues: 6:30 am-11:30 am; Wed: 6:30 am-11:30 am; Thurs: 6:30 am-11:30 am; Fri: 6:30 am-11:30 am; 345 Main St Harleysville, PA Phone: (215) Fax: (215) Allendale Rd Ste 111 King of Prussia, PA Phone: (610) Fax: (610) Sat: 8:00 am-12:00 pm 515 Pennsylvania Ave Fort Washington, PA Phone: (215) Fax: (215) Mon: 7:30 am-12:00 pm Tues: 7:30 am-12:00 pm Wed: 7:30 am-12:00 pm Thurs: 7:30 am-12:00 pm Fri: 7:30 am-12:00 pm 555 2nd Ave Collegeville, PA Phone: (610) Fax: (610) Mon: 7:30 am-1:00 pm Tues: 7:30 am-1:00 pm Wed: 7:30 am-1:00 pm Thurs: 7:30 am-1:00 pm Fri: 7:30 am-1:00 pm 599 Arcola Rd Collegeville, PA Phone: (610) Mon: 7:45 am-12:30 pm; 1:00 pm-4:00 pm Tues: 7:45 am-12:30 pm; 1:00 pm-4:00 pm Wed: 7:45 am-12:30 pm; 1:00 pm-4:00 pm Thurs: 7:45 am-12:30 pm; 1:00 pm-4:00 pm Fri: 7:45 am-12:30 pm; 1:00 pm-4:00 pm 622 Gravel Pike East Greenville, PA Phone: (215) Fax: (610) Mon: 7:00 am-3:30 pm Tues: 7:00 am-3:30 pm Wed: 7:00 am-3:30 pm Thurs: 7:00 am-3:30 pm Fri: 7:00 am-3:30 pm Sat: 7:00 am-11:00 am 628 Old Rd Ste 628 Jenkintown, PA Phone: (215) Fax: (215) Rte 113 Souderton, PA Phone: (215) Fax: (215) Mon: 6:30 am-11:30 am; Tues: 6:30 am-11:30 am; Wed: 6:30 am-11:30 am; Thurs: 6:30 am-11:30 am; Fri: 6:30 am-11:30 am; Sat: 8:00 am-11:30 am E Johnson Hwy Norristown, PA Phone: (610) Fax: (610) Mon: 6:30 am-3:00 pm Tues: 6:30 am-3:00 pm Wed: 6:30 am-3:00 pm Thurs: 6:30 am-3:00 pm Fri: 6:30 am-3:00 pm Sat: 8:00 am-12:00 pm 724 DeKalb Pike Blue Bell, PA Phone: (610) Fax: (610) Limerick Sq 70 Buckwalter Rd Royersford, PA Phone: (610) Fax: (610) Mon: 7:00 am-12:00 pm; 12:45 pm-3:00 pm Tues: 7:00 am-12:00 pm; 12:45 pm-3:00 pm Wed: 7:00 am-12:00 pm; 12:45 pm-3:00 pm Thurs: 7:00 am-12:00 pm; 12:45 pm-3:00 pm Fri: 7:00 am-12:00 pm; 12:45 pm-3:00 pm MainLine Health Lab 233 E Ave Ste 100A Ardmore, PA Phone: (484) Fax: (484) Mon: 6:30 am-5:00 pm Tues: 6:30 am-5:00 pm Wed: 6:30 am-5:00 pm Thurs: 6:30 am-5:00 pm Fri: 6:30 am-5:00 pm Quest Diagnostics 2045 Westgate Dr Ste 306 Phone: (610) Fax: (610) Mon: 6:30 am-3:00 pm Tues: 6:30 am-3:00 pm Wed: 6:30 am-3:00 pm Thurs: 6:30 am-3:00 pm Fri: 6:30 am-3:00 pm Sat: 7:00 am-11:00 am 229 S 22nd St Easton, PA Phone: (610) Fax: (610) Mon: 6:30 am-3:00 pm Tues: 6:30 am-3:00 pm Wed: 6:30 am-3:00 pm Thurs: 6:30 am-3:00 pm Fri: 6:30 am-3:00 pm Sat: 7:00 am-11:00 am 25 S Broad St Ste 102 Nazareth, PA Phone: (610) Fax: (610) Mon: 7:00 am-12:30 pm Tues: 7:00 am-12:30 pm Wed: 7:00 am-12:30 pm Thurs: 7:00 am-12:30 pm Fri: 7:00 am-12:30 pm 3601 Nazareth Rd Easton, PA Phone: (610) Fax: (610) Mon: 6:30 am-4:00 pm Tues: 6:30 am-4:00 pm Wed: 6:30 am-4:00 pm Thurs: 6:30 am-4:00 pm Fri: 6:30 am-4:00 pm Sat: 8:00 am-12:00 pm 406 Delaware Ave Bethlehem, PA Phone: (610) Fax: (610) Mon: 6:30 am-1:30 pm Tues: 6:30 am-1:30 pm Wed: 6:30 am-1:30 pm Thurs: 6:30 am-1:30 pm Fri: 6:30 am-1:30 pm 4333 Easton Ave Ste A Bethlehem, PA Phone: (610) Fax: (610) Mon: 6:30 am-5:00 pm Tues: 6:30 am-5:00 pm Wed: 6:30 am-5:00 pm Thurs: 6:30 am-5:00 pm Fri: 6:30 am-5:00 pm Sat: 7:00 am-11:00 am Rte Blue Valley Dr Bangor, PA Phone: (610) Fax: (610) Mon: 7:00 am-3:00 pm Tues: 7:00 am-3:00 pm Wed: 7:00 am-3:00 pm Thurs: 7:00 am-3:00 pm Fri: 7:00 am-3:00 pm Sat: 7:30 am-11:30 am Sacred Heart Hospital 2014 Laubach Ave, PA Phone: (610) Mon: 8:00 am-5:00 pm Tues: 8:00 am-5:00 pm Wed: 8:00 am-5:00 pm Thurs: 8:00 am-5:00 pm Fri: 8:00 am-5:00 pm The Shoppes at Hellertown 25 Main St Hellertown, PA Phone: (610) Fax: (610) Mon: 7:00 am-12:00 pm; 12:30 pm-2:00 pm Tues: 7:00 am-12:00 pm; 12:30 pm-2:00 pm Wed: 7:00 am-12:00 pm; 12:30 pm-2:00 pm Thurs: 7:00 am-12:00 pm; 12:30 pm-2:00 pm Fri: 7:00 am-12:00 pm; 12:30 pm-2:00 pm Sat: 7:00 am-11:00 am Schuylkill Quest Diagnostics 1851 W End Ave Pottsville, PA Phone: (570) Fax: (570) Mon: 8:00 am-11:00 am; 11:30 am-2:00 pm Tues: 8:00 am-11:00 am; 11:30 am-2:00 pm Wed: 8:00 am-11:00 am; 11:30 am-2:00 pm Thurs: 8:00 am-11:00 am; 11:30 am-2:00 pm Fri: 8:00 am-11:00 am; 11:30 am-2:00 pm Schuylkill Medical Ctr 700 E Norwegian St Pottsville, PA Phone: (717) Mon: 8:00 am-5:00 pm Tues: 8:00 am-5:00 pm Wed: 8:00 am-5:00 pm Thurs: 8:00 am-5:00 pm Fri: 8:00 am-5:00 pm St Catherine Med Ctr 101 Broad St Ashland, PA Phone: (570) Mon: 8:00 am-5:00 pm Tues: 8:00 am-5:00 pm Wed: 8:00 am-5:00 pm Thurs: 8:00 am-5:00 pm Fri: 8:00 am-5:00 pm St Joseph Quality Med Lab 5 W Washington St Shenandoah, PA Phone: (570) Mon: 8:00 am-5:00 pm Tues: 8:00 am-5:00 pm Wed: 8:00 am-5:00 pm Thurs: 8:00 am-5:00 pm Fri: 8:00 am-5:00 pm St Lukes Miners Mem Hosp 360 W Ruddle St Coaldale, PA Phone: (570) Mon: 8:00 am-4:00 pm Tues: 8:00 am-4:00 pm Wed: 8:00 am-4:00 pm Thurs: 8:00 am-4:00 pm Fri: 8:00 am-4:00 pm Union Quest Diagnostics Evangelical Counity Hosp 1 Hospital Dr Lewisburg, PA Phone: (570) Mon: 7:00 am-7:00 pm Tues: 7:00 am-7:00 pm Wed: 7:00 am-7:00 pm Thurs: 7:00 am-7:00 pm Fri: 7:00 am-7:00 pm Sat: 7:00 am-12:00 pm Quest Diagnostics th Ave, PA Phone: (717) Fax: (717) Mon: 7:00 am-11:00 am; 12:00 pm-3:30 pm Tues: 7:00 am-11:00 am; 12:00 pm-3:30 pm Wed: 7:00 am-11:00 am; 12:00 pm-3:30 pm Thurs: 7:00 am-11:00 am; 12:00 pm-3:30 pm Fri: 7:00 am-11:00 am; 12:00 pm-3:30 pm Sat: 8:00 am-12:00 pm Crossings 2189 Crossing Dr, PA Phone: (717) Fax: (717) Mon: 6:30 am-1:00 pm Tues: 6:30 am-1:00 pm Wed: 6:30 am-1:00 pm Thurs: 6:30 am-1:00 pm Fri: 6:30 am-1:00 pm Page 40

35 LABORATORIES DRAW CENTERS HEALTH NETWORK LABORATORIES The following section lists Health Network Laboratories (HNL) Patient Service s. SecureChoice SM Members who have a PCP that is part of the Valley Physician Hospital Organization (LVPHO) must obtain laboratory services through HNL for such Members, specimens for all routine outpatient laboratory services must either be drawn in the participating provider s office and sent to HNL, or be drawn at an HNL Patient Service. SecureChoice SM Members should contact their PCP, or Capital BlueCross Customer Service, for information concerning their PCP s laboratory arrangements. Important Notes Information regarding individual HNL Patient Service hours of operation, driving directions, and telephone number are available at healthnetworklabs.com. Members may use the Patient Service Locator on the home page or may contact HNL s 24-hour customer service line for assistance at 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 41

36 Health Network Laboratories CBC # NPI/Ref # Hamburg Co Hlth Ctr 700 Hawk Ridge Dr Hamburg Phone: (610) Fax: (610) Kutztown Professional Ctr 333 Normal Ave Ste 101 Kutztown Phone: (610) Fax: (610) West Reading Shopping Ctr 525 Penn Ave Reading Phone: (610) Fax: (610) Bucks Health Network Laboratories CBC # NPI/Ref # Oxford Ct Business Ctr 582 Middletown Blvd B-11 Langhorne Phone: (215) Fax: (215) Quakertown Atrium 127 S 5th St Ste 195 Quakertown Phone: (215) Fax: (215) Carbon Health Network Laboratories CBC # NPI/Ref # Mahoning St Ste 3A ton Phone: (610) Fax: (610) Health Network Laboratories CBC # NPI/Ref # Walnut Bottom Rd Carlisle Phone: (717) Fax: (717) Franklin Health Network Laboratories CBC # NPI/Ref # Phoenix Dr Chambersburg Phone: (717) Fax: (717) Health Network Laboratories CBC # NPI/Ref # A Granite Run Dr Phone: (717) Fax: (717) Health Network Laboratories CBC # NPI/Ref # Schneider Dr Ste Phone: (717) Fax: (717) Health Network Laboratories CBC # NPI/Ref # Chestnut St Eaus Phone: (610) Fax: (610) S Cedar Crest Blvd Ste 103C Allentown Phone: (610) Fax: (610) N Cedar Crest Blvd Allentown Phone: (484) Fax: (484) St Allentown Phone: (610) Fax: (610) Hausman Rd Allentown Phone: (610) Fax: (610) Allentown Medical Ctr 401 N 17th St Ste 108 Allentown Phone: (610) Fax: (610) Health Ctr at Trexlertown 6900 Hamilton Blvd Trexlertown Phone: (610) Fax: (610) Valley Hospital 17th & Chew Sts Allentown Phone: (610) Fax: (610) Valley Hospital Diagnostic Care Ctr/Jaindl Pavilion 1200 S Cedar Crest Blvd Allentown Phone: (610) Fax: (610) Riverside Prof Ctr 5649 Wynnewood Dr Ste 204 Laurys Station Phone: (610) Fax: (610) Monroe Health Network Laboratories CBC # NPI/Ref # Independence Rd East Stroudsburg Phone: (570) Fax: (570) Rte 15 & Switzgable Dr Brodheadsville Phone: (570) Fax: (570) Health Network Laboratories CBC # NPI/Ref # N 11th St Bangor Phone: (610) Fax: (610) Franklin St Ste C Phone: (610) Fax: (610) B Schoenersville Rd & Ave C Bethlehem Phone: (610) Fax: (610) Bangor Jct Rd Bangor Phone: (610) Fax: (610) Bath Co Med Ctr 6649 Chrisphalt Dr Bath Phone: (610) Fax: (610) Health Ctr at Bethlehem Twp 2101 Emrick Blvd Bethlehem Phone: (610) Fax: (610) Health Ctr at Hellertown 1072 Main St Hellertown Phone: (610) Fax: (610) Valley Hosp - Muhlenberg 2545 Schoenersville Rd Bethlehem Phone: (484) Fax: (484) Northwood Surgery Prof Bldg 3729 Easton Nazareth Hwy Ste 102 Easton Phone: (610) Fax: (610) HEALTH NETWORK LABORATORIES Page 43

37 FOR INFORMATION CALL CUSTOMER SERVICE MONDAY through FRIDAY 8 a.m. to 6 p.m. EST (TTY 711) If you require information presented in this directory in a language other than English, please call our Customer Service Department at (TTY 711), Monday through Friday, 8 a.m. to 6 p.m. EST, and ask for interpreting services. Si usted requiere información presentada en este directorio en otro idioma aparte de inglés, por favor llame a nuestro Departamento del Servicio al Cliente al (TTY 711), de lunes a viernes de 8 a.m. a 6 p.m. tiempo del este y pida los servicios de interpretación. SecureChoice SM is an HMO issued by Keystone Health Plan Central through a contract with the Coonwealth of Pennsylvania. Healthy PA is funded by the Coonwealth of Pennsylvania. Vision coverage is issued by Capital Advantage Assurance Company. Capital Advantage Assurance Company and Keystone Health Plan Central are subsidiaries of Capital BlueCross. All are independent licensees of the BlueCross BlueShield Association. Counications are issued by Capital BlueCross in its capacity as administrator of programs and provider relations. HPA-3 (11/2014)