1124261771 NPI number — KHS AMBULATORY SURGERY CENTER, LLC

Table of content: EMILY CATHERINE AMADOR DO (NPI 1922666775)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124261771 NPI number — KHS AMBULATORY SURGERY CENTER, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KHS AMBULATORY SURGERY CENTER, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124261771
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/08/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
405 HURFFVILLE CROSSKEYS RD
Provider Second Line Business Mailing Address:
STE 210
Provider Business Mailing Address City Name:
SEWELL
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08080-9344
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-582-2072
Provider Business Mailing Address Fax Number:
856-582-8073

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
405 HURFFVILLE CROSS KEYS RD
Provider Second Line Business Practice Location Address:
SUITE 210
Provider Business Practice Location Address City Name:
SEWELL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08080
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-582-2072
Provider Business Practice Location Address Fax Number:
856-582-8073
Provider Enumeration Date:
04/13/2009

Additional Information

Authorized Official

Authorized Official Last Name:
OCONNOR
Authorized Official First Name:
KRISTEN
Authorized Official Middle Name:
Authorized Official Title or Position:
AUTHORIZED OFFICIAL / OFFICER
Authorized Official Telephone Number:
615-376-7315

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  24339 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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