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Lorene Ruth Mann

Internal Medicine

Allopathic & Osteopathic Physicians

4300 Londonderry Rd, Harrisburg, PA 17109-5317

PECOS Enrollment

This provider is enrolled in PECOS as LORENE MANN.

Based on the most recent information from CMS, provider Lorene Ruth Mann 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 15 days ago.

Profile Details

Provider ID
1851646814
Provider Type
Individual
Full Name
Mann, Lorene Ruth
Title
Dr.
Credential
MD

Gender
Female
Sole Proprietor
No
Enumeration Date
7/16/2012
Last Updated
3/30/2017

Contact Information

Practice Location

4300 Londonderry Rd, Harrisburg, PA 17109-5317

(717) 231-8772

(717) 231-8435

Mailing Location

409 S 2nd St, Suite 2f, Harrisburg, PA 17104-1612

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License MD455709 Pennsylvania
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License MT201068 Pennsylvania

Provider Identifiers

ID	Description	Issuer
ID 103073980	Description Medicaid	Issuer Unlisted Pennsylvania

Lorene Ruth Mann

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Kreiser, Juanita Marie

Alcaraz-Angulo, Fabian

Heritage Medical Group, Llp

Dailey, Elena R

Doody, Alyssa

Pinnacle Health Medical Group Inc

Wagner, Kristina M

Allen, Anne Valerie

Cheriyath, Pramil

Heckenluber, Steven G