| Organization Name: | OAKHURST ENDOSCOPY ASC LLC |
| NPI Number: | 1205809795 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PHILLIP CLENDENIN (CHIEF MANAGER OF LLC) |
| Mailing Address: | 1907 Highway 35 Suite 9 Oakhurst |
| State: | NJ US |
| Postal Code: | 077552765 |
| Phone Number: | 7325178885 |
| Fax Number: | 7325170304 |
| NPI Enumeration Date: | 02/07/2006 |
| NPI Last Update Date: | 12/02/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | NONE REQUIRED |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |