| Organization Name: | MINE HILL SURGICAL CENTER LLC |
| NPI Number: | 1184977886 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TIFFANY J MARSH (ADMINITRATOR) |
| Mailing Address: | 195 Route 46 Suite 202 Mine Hill |
| State: | NJ US |
| Postal Code: | 078032302 |
| Phone Number: | 9739895185 |
| Fax Number: | 9734337235 |
| NPI Enumeration Date: | 10/18/2012 |
| NPI Last Update Date: | 10/18/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |