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General NPI Number Information
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NPI Number | 1346269784
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Entity Type | Organization
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Legal Business Name | SCHUYLKILL ENDOSCOPY CENTER
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 11/08/2007
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Provider Practice Location Address
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Address Line | 48 TUNNEL RD SUITE 103
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City | POTTSVILLE
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State | PA
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Zip | 17901-3875
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Country | US
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Telephone | 570-622-6520
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Fax |
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Provider Business Mailing Address
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Address Line | 48 TUNNEL RD SUITE 103
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City | POTTSVILLE
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State | PA
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Zip | 17901-3875
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Country | US
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Telephone | 570-622-6520
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Fax |
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Authorized Official
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Title or Position | PRESIDENT OF THE GENERAL PARTNER
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Name | MR. CHRISTOPHER A HOLDEN
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Credential |
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Telephone | 615-665-1283
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0800X
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Taxonomy Name | Endoscopy Clinic/Center
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License Number | 17381501
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License Number State | PA
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