Healthcare Provider Details

I. General information

NPI: 1629013164
Provider Name (Legal Business Name): CHAMBERSBURG ENDOSCOPY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 05/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 5TH AVE
CHAMBERSBURG PA
17201-4224
US

IV. Provider business mailing address

835 5TH AVE
CHAMBERSBURG PA
17201-4224
US

V. Phone/Fax

Practice location:
  • Phone: 717-217-4312
  • Fax:
Mailing address:
  • Phone: 717-217-4312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOYCE BURKHOLDER
Title or Position: CENTER DIRECTOR
Credential: BSN, RN
Phone: 717-217-4328