=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508839473
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NEWARK ENDOSCOPY ASC LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/09/2006
-----------------------------------------------------
Last Update Date | 11/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1090 OLD CHURCHMANS RD
-----------------------------------------------------
City | NEWARK
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19713-2102
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-892-2710
-----------------------------------------------------
Fax | 302-892-2715
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1A BURTON HILLS BLVD STE 300
-----------------------------------------------------
City | NASHVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37215-6153
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-263-4011
-----------------------------------------------------
Fax | 615-234-1720
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. JEFFREY SNODGRASS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 615-665-1283
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA1903X
-----------------------------------------------------
Taxonomy Name | Ambulatory Surgical Clinic/Center
-----------------------------------------------------
License Number | NONE REQUIRED
-----------------------------------------------------
License Number State | DE
-----------------------------------------------------