1932256278 NPI number — THE SURGERY CENTER OF SALEM COUNTY LLC

Table of content: (NPI 1932256278)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932256278 NPI number — THE SURGERY CENTER OF SALEM COUNTY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE SURGERY CENTER OF SALEM COUNTY 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:
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:
1932256278
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/31/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7100 COMMERCE WAY
Provider Second Line Business Mailing Address:
SUITE 180
Provider Business Mailing Address City Name:
BRENTWOOD
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37027-2829
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
336 WOODSTOWN RD.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALEM
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08079
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-339-4220
Provider Business Practice Location Address Fax Number:
856-339-4286
Provider Enumeration Date:
01/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BREWER
Authorized Official First Name:
DEBBIE
Authorized Official Middle Name:
T
Authorized Official Title or Position:
DIRECTOR OF PROVIDER ENROLLMENT
Authorized Official Telephone Number:
877-892-9813

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  22463 , 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)

  • Identifier: 0001559000 . This is a "KEYSTONE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2095428 . This is a "AETNA USHC" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0001559000 . This is a "BC PERSONAL CHOICE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 31110 . This is a "BC HORIZON" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0001559000 . This is a "AMERIHEALTH HMO" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 5889680 . This is a "AETNA PPO" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com