National Provider Identifier Database

SURGERY CENTER OF PENNSYLVANIA LLC
Ambulatory Surgical


Contact Information

SURGERY CENTER OF PENNSYLVANIA, LLC
2010 W CHESTER PIKE
SUITE 212
HAVERTOWN, PA19083-2700
Phone: 610-853-7700
Fax: 610-853-7755
Website:
Specialty Taxonomy Code
* Ambulatory Surgical 261QA1903X

* Indicates primary specialty

NPI Profile & details for SURGERY CENTER OF PENNSYLVANIA, LLC

NPI Number 1922025006
Legal business name
LBN
SURGERY CENTER OF PENNSYLVANIA, LLC
Authorized official DEBORAH TUCKER - (DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 07/16/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • PA License #: 10271500
  • PA Medicaid: 0019414000001
  • PA Other: 3052119 AETNA
  • PA Other: 1618 INDEPENDENCE BLUE CROSS
  • PA Other: 0001618000 KEYSTONE HEALTH PLAN EAST
  • PA Other: 30005351 KEYSTONE MERCY HEALTH PLA

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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