OrganizationHettick Internal MedicineInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address4319 Londonderry Rd, Harrisburg, PA 17109-5318(717) 541-1400PECOS EnrollmentBased on the most recent information from CMS, provider Hettick Internal Medicine does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 15 days ago.Profile DetailsProvider ID1700996030Provider TypeOrganizationFull NameHettick Internal MedicineSubpartNoEnumeration Date8/30/2006Last Updated9/3/2009Contact InformationPractice LocationPractice Address4319 Londonderry Rd, Harrisburg, PA 17109-5318Phone(717) 541-1400Fax(717) 541-8080Mailing LocationMailing Address4319 Londonderry Rd, Harrisburg, PA 17109-5318Phone(717) 541-1400Fax(717) 541-8080Authorized OfficialNameHettick, Jamie L (Provider)Phone(717) 541-1400Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseMD047575LPennsylvania