MEDICARE: COLLEGE HEIGHTS ENDOSCOPY CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0800X	Endoscopy Clinic/Center
2	261QA1903X	Ambulatory Surgical Clinic/Center	15861501	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	490005657	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780686808
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLLEGE HEIGHTS ENDOSCOPY CENTER LLC

Provider Business Mailing Address
First Line	:	1A BURTON HILLS BLVD # L&C
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-6187
Country	:	US
Telephone Number	:	615-240-3820
Fax Number	:	615-234-1720

Provider Business Practice Location Address
First Line	:	3147 COLLEGE HEIGHTS BLVD
Second Line	:
City	:	ALLENTOWN
State	:	PA
Zip	:	18104-4813
Country	:	US
Telephone Number	:	610-841-2432
Fax Number	:	610-841-4433

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JEFFREY SNODGRASS
Credential	:
Telephone Number	:	615-665-1283

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	12/14/2022

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Directions to “COLLEGE HEIGHTS ENDOSCOPY CENTER LLC ” Practice Location

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