| Organization Name: | GLOUCESTER COUNTY SURGERY CENTER, LLC |
| NPI Number: | 1073759015 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRUCE MONAGHAN (CHAIRMAN) |
| Mailing Address: | 163 Bridgeton Pike Building B Mullica Hill |
| State: | NJ US |
| Postal Code: | 080622669 |
| Phone Number: | 8564784222 |
| Fax Number: | 8564784408 |
| NPI Enumeration Date: | 12/22/2008 |
| NPI Last Update Date: | 05/11/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 0400190493 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |