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General NPI Number Information
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NPI Number | 1134987357
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Entity Type | Organization
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Legal Business Name | MAIN LINE SURGICAL CENTER LLC
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Dates
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Enumeration Date | 03/12/2024
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Last Update Date | 04/24/2024
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Provider Practice Location Address
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Address Line | 333 E. CITY AVENUE 2 BALA PLAZA PL35
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City | BALA CYNWYD
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State | PA
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Zip | 19004
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Country | US
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Telephone | 267-401-8512
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Fax |
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Provider Business Mailing Address
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Address Line | 2 BALA PLAZA PL35 333 E. CITY AVENUE
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City | BALA CYNWYD
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State | PA
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Zip | 19004
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Country | US
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Telephone | 267-401-8512
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ARSELA GJELI
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Credential |
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Telephone | 267-401-8512
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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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