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Rodrigo Jose Ugalde

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

2112 Harrisburg Pike Ste 200, Lancaster, PA 17601-2644

PECOS Enrollment

This provider is enrolled in PECOS as RODRIGO UGALDE.

Based on the most recent information from CMS, provider Rodrigo Jose Ugalde is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1619482437
Provider Type
Individual
Full Name
Ugalde, Rodrigo Jose
Credential
CRNP

Gender
Male
Sole Proprietor
No
Enumeration Date
12/4/2017
Last Updated
4/28/2022

Contact Information

Practice Location

2112 Harrisburg Pike Ste 200, Lancaster, PA 17601-2644

(717) 544-3059

Unlisted Fax

Mailing Location

2112 Harrisburg Pike Ste 200, Lancaster, PA 17601-2644

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License SP018067 Pennsylvania

Rodrigo Jose Ugalde

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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Rivera-Rodriquez, Madelyn

Wettig, Vicki S

Daniels, Lisa

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Reeher, Emily Jean

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