Healthcare Provider Details

I. General information

NPI: 1326040668
Provider Name (Legal Business Name): READING ENDOSCOPY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 04/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GRANITE POINT DRIVE SUITE 370
WYOMISSING PA
19610-1986
US

IV. Provider business mailing address

1 GRANITE POINT DRIVE SUITE 370
WYOMISSING PA
19610-1986
US

V. Phone/Fax

Practice location:
  • Phone: 610-685-5757
  • Fax: 610-685-5135
Mailing address:
  • Phone: 610-685-5757
  • Fax: 610-685-5135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number17831501
License Number StatePA

VIII. Authorized Official

Name: MR. KATHERINE L. REED
Title or Position: OFFICER, MEDICARE AUTHORIZED OFFICI
Credential:
Phone: 972-763-3859