Organization Name: | SURGICAL SPECIALTY CENTER OF NORTHEASTERN PENNSYLVANIA, LLC |
NPI Number: | 1245233410 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JULIE BINGHAM (BUSINESS MANAGER) |
Mailing Address: | 190 Welles St Forty Fort |
State: | PA US |
Postal Code: | 187044968 |
Phone Number: | 5703317615 |
Fax Number: | 5703317614 |
NPI Enumeration Date: | 05/23/2005 |
NPI Last Update Date: | 04/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA1903X |
License Number: | 148601 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Ambulatory Surgical |
Taxonomy Definition: |