MEDICARE: VISTA SURGERY CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center	NA	PA

General Provider Information

NPI Number	:	1225082928
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISTA SURGERY CENTER

Provider Business Mailing Address
First Line	:	205 GRANDVIEW AVE
Second Line	:	SUITE 401
City	:	CAMP HILL
State	:	PA
Zip	:	17011-1708
Country	:	US
Telephone Number	:	717-763-7814
Fax Number	:	717-763-4918

Provider Business Practice Location Address
First Line	:	205 GRANDVIEW AVE
Second Line	:	SUITE 401
City	:	CAMP HILL
State	:	PA
Zip	:	17011-1708
Country	:	US
Telephone Number	:	717-763-7814
Fax Number	:	717-763-4918

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. JAMES A YATES
Credential	:	MD
Telephone Number	:	717-763-7814

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	08/22/2020

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Directions to “VISTA SURGERY CENTER ” Practice Location

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