Individual ProviderAndrew LichliterRadiologyAllopathic & Osteopathic PhysiciansPractice Address100 North Academy Ave, Danville, PA 17822-9800(570) 271-6301PECOS EnrollmentBased on the most recent information from CMS, provider Andrew Lichliter is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 34 days ago.Profile DetailsProvider ID1124447107Provider TypeIndividualFull NameLichliter, AndrewCredentialMDGenderMaleSole ProprietorYesEnumeration Date4/7/2014Last Updated7/2/2025Contact InformationPractice LocationPractice Address100 North Academy Ave, Danville, PA 17822-9800Phone(570) 271-6301Fax(570) 271-5976Mailing LocationMailing Address100 N Academy Ave, Danville, PA 17822-4903Phone(570) 271-6301Fax(570) 271-5976Provider TaxonomiesCodeDescriptionLicenseCode2085R0202XPrimaryDescriptionRadiologyAllopathic & Osteopathic PhysiciansLicenseMD486849PennsylvaniaCode2085R0202XDescriptionRadiologyAllopathic & Osteopathic PhysiciansLicenseQ8099TexasCode2085R0204XDescriptionRadiologyAllopathic & Osteopathic PhysiciansLicense61720TennesseeProvider IdentifiersIDDescriptionIssuerID363303401DescriptionMedicaidIssuerUnlistedTexas