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General NPI Number Information
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NPI Number | 1063685980
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Entity Type | Organization
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Legal Business Name | SUSQUEHANNA ENDOSCOPY CENTER, LLC
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Dates
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Enumeration Date | 04/11/2008
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Last Update Date | 10/11/2016
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Provider Practice Location Address
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Address Line | 10 CHOATE CIRCLE
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City | MONTOURSVILLE
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State | PA
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Zip | 17754
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Country | US
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Telephone | 570-368-5581
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Fax | 570-368-5564
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Provider Business Mailing Address
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Address Line | 10 CHOATE CIRCLE
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City | MONTOURSVILLE
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State | PA
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Zip | 17754
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Country | US
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Telephone | 570-368-5581
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Fax | 570-368-5564
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | HOLLY M NEUHARD
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Credential |
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Telephone | 570-368-5561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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