| Organization Name: | MASONIC HOMES AT ELIZABETHTOWN LG LDG OF FREE & ACCPTD MASONS PA |
| NPI Number: | 1871551085 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIAM J. PRAZENICA (CHIEF FINANCIAL OFFICER) |
| Mailing Address: | 1 Masonic Dr Elizabethtown |
| State: | PA US |
| Postal Code: | 170222199 |
| Phone Number: | 7173671121 |
| Fax Number: | 7173675813 |
| NPI Enumeration Date: | 05/04/2006 |
| NPI Last Update Date: | 05/19/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |