MEDICARE: FLORHAM PARK ENDOSCOPY ASC 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	261QA1903X	Ambulatory Surgical Clinic/Center	22749	NJ

Other Identifiers

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

General Provider Information

NPI Number	:	1881667368
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORHAM PARK ENDOSCOPY ASC LLC

Provider Business Mailing Address
First Line	:	1A BURTON HILLS BLVD
Second Line	:	ATTN: L&C
City	:	NASHVILLE
State	:	TN
Zip	:	37215-6103
Country	:	US
Telephone Number	:	615-665-1283
Fax Number	:	615-234-1720

Provider Business Practice Location Address
First Line	:	195 COLUMBIA TPKE
Second Line	:
City	:	FLORHAM PARK
State	:	NJ
Zip	:	07932-2254
Country	:	US
Telephone Number	:	973-410-1800
Fax Number	:	973-410-0959

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

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	11/23/2022

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