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General NPI Number Information
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NPI Number | 1447489695
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Entity Type | Organization
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Legal Business Name | AMBULATORY SURGERY CENTER AT VIRTUA WASHINGTON TOWNSHIP, L.L.C.
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Dates
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Enumeration Date | 07/09/2009
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Last Update Date | 11/23/2009
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Provider Practice Location Address
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Address Line | 239 HURFFVILLE CROSSKEYS RD
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City | SEWELL
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State | NJ
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Zip | 08080-4001
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Country | US
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Telephone | 479-267-2756
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Fax |
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Provider Business Mailing Address
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Address Line | 11641 CHARLES CT
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City | FARMINGTON
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State | AR
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Zip | 72730-8782
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Country | US
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Telephone | 479-267-2756
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Fax | 479-267-2757
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Authorized Official
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Title or Position | MANAGER
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Name | DEBRA STINCHCOMB
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Credential | RN, BSN, CASC
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Telephone | 479-267-2756
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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 | NJ
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