1164490728 NPI number — THE READING HOSPITAL SURGICENTER AT SPRING RIDGE LLC

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164490728 NPI number — THE READING HOSPITAL SURGICENTER AT SPRING RIDGE LLC

Employer Identification Number (EIN):

Provider Organization Name:

THE READING HOSPITAL SURGICENTER AT SPRING RIDGE LLC

Provider Last Name:

Provider First Name:

Provider Middle Name:

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Provider Credential Text:

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Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

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Provider Other Last Name Type Code:

NPI Number:

1164490728

Entity Type Code:

Organization

Replacement NPI:

Last Update Date:

04/20/2021

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

2603 KEISER BLVD

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

WYOMISSING

Provider Business Mailing Address State Name:

PA

Provider Business Mailing Address Postal Code:

19610-3341

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

484-628-3050

Provider Business Mailing Address Fax Number:

484-628-3020

Provider First Line Business Practice Location Address:

2603 KEISER BLVD

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

WYOMISSING

Provider Business Practice Location Address State Name:

PA

Provider Business Practice Location Address Postal Code:

19610-3341

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

610-568-3050

Provider Business Practice Location Address Fax Number:

610-568-3020

Provider Enumeration Date:

03/09/2006

Authorized Official Last Name:

ERTEL

Authorized Official First Name:

PAMELA

Authorized Official Middle Name:

J

Authorized Official Title or Position:

ADMINISTRATIVE DIRECTOR

Authorized Official Telephone Number:

484-628-3050

• Taxonomy code: 261QA1903X , with the licence number:  16481501 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 168724 . This is a "UNISON" identifier . This identifiers is of the category "OTHER".
• Identifier: 13011 . This is a "HEALTH GUARD" identifier . This identifiers is of the category "OTHER".
• Identifier: 6929779 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
• Identifier: 0001391000 . This is a "INDEPENDENCE BC" identifier . This identifiers is of the category "OTHER".
• Identifier: 0390857 . This is a "KEYSTONE HEALTH PLAN CENT" identifier . This identifiers is of the category "OTHER".
• Identifier: 001391 . This is a "KEYSTONE EAST" identifier . This identifiers is of the category "OTHER".
• Identifier: 30023577 . This is a "KEYSTONE MERCY HEALTH PLA" identifier . This identifiers is of the category "OTHER".
• Identifier: 0247 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: C99480 . This is a "AMERIHEALTH ADMINISTRATOR" identifier . This identifiers is of the category "OTHER".
• Identifier: 1012727600001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
• Identifier: 390857 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 7309604 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".