Healthcare Provider Details

I. General information

NPI: 1710091517
Provider Name (Legal Business Name): HERSHEY OUTPATIENT SURGERY CENTER LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 HOPE DR
HERSHEY PA
17033-2086
US

IV. Provider business mailing address

15 HOPE DR
HERSHEY PA
17033-2086
US

V. Phone/Fax

Practice location:
  • Phone: 717-520-8200
  • Fax: 717-835-0215
Mailing address:
  • Phone: 717-520-8200
  • Fax: 717-835-0215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number16721501
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JONATHAN BAILEY
Title or Position: OFFICER, AUTHORIZED OFFICIAL
Credential:
Phone: 203-609-1168