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Provider Demographic Information - ODP Provider Three

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Below Is the information you requested on the individual or agency ODP Provider Three. Select from the options on the right to view specific information of interest to you. As this information may change, please check back often for the most up-to-date information.

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PROVIDER DEMOGRAPHIC INFORMATION Supporting line for group header


Name:	ODP Provider Three
Address:	234 DEPAUL ST NEW CUMBERLAND, PA 17070-1634
Phone:	(717) 555-0003
Web Site:	N/A

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PROVIDER CERTIFICATION INFORMATION Supporting line for group header

Click here to view Provider Certification Information

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PROVIDER'S PARENT/ REGIONAL OFFICE Supporting line for group header


Type:	Corporate Office
Name:	New parent
Address:	300 Corporate Cirlce DR camp hill, PA 17110
Phone:	(717) 555-5555

Type:	Corporate Office
Name:	Parent One
Address:	207 E. UNION Camp Hill, PA 17110
Phone:	(717) 555-5555

Type:	Corporate Office
Name:	Parent Three
Address:	300 STERLING PKWY MECHANICSBURG, PA 17050-2937
Phone:	(717) 555-5555

Type:	Corporate Office
Name:	Parent Two
Address:	ELMLEY AVE MECHANICSBURG, PA 17050-2938
Phone:	(717) 555-5555

Type:	Regional/Field Office	Counties Served:
Name:	Region Two
Address:	ELMLEY AVE MECHANICSBURG, PA 17050-2938
Phone:	(717) 555-5555

Type:	Regional/Field Office		Counties Served:
Name:	Region Three
Address:	300 STERLING PKWY MECHANICSBURG, PA 17050-2937
Phone:	(717) 555-5555

Type:	Regional/Field Office	Counties Served:
Name:	Region One
Address:	207 E. UNION Camp Hill, PA 17110
Phone:	(717) 555-5555

Type:	Regional/Field Office		Counties Served:
Name:	New Region
Address:	80 WELSCH RD, PA 19341 Camp Hill, PA 17110
Phone:	(717) 555-5555

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PROVIDER SERVICES AND RATES Supporting line for group header


County : Allegheny
\|Service Name / Level	\|Rate

DTT ODP SDC REPORT SORT TEST SD	Not Set

County : Armstrong/Indiana
\|Service Name / Level	\|Rate

DTT ODP Consolidated Combo Service	Not Set
DTT ODP Consolidated Corticon Service	Not Set
DTT ODP Consolidated Equivalent Service	Not Set
DTT ODP SDC REPORT SORT TEST SD	Not Set

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