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General NPI Number Information
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NPI Number | 1184678682
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Entity Type | Organization
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Legal Business Name | MAIN LINE SURGERY CENTER, LLC
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 04/16/2024
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Provider Practice Location Address
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Address Line | 10 PRESIDENTIAL BLVD SUITE 200
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City | BALA CYNWYD
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State | PA
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Zip | 19004-1107
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Country | US
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Telephone | 610-660-9066
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Fax | 610-949-9069
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Provider Business Mailing Address
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Address Line | 10 PRESIDENTIAL BLVD SUITE 200
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City | BALA CYNWYD
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State | PA
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Zip | 19004-1107
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Country | US
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Telephone | 610-660-9066
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Fax | 610-949-9069
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. ANNE BARRETT STERNBERG
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Credential |
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Telephone | 610-660-8437
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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 | 10321500
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License Number State | PA
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