Provider Demographics
NPI:1528797818
Name:EAST NORRITON SURGICAL CENTER, LLC
Entity type:Organization
Organization Name:EAST NORRITON SURGICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNDLMAIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-499-4659
Mailing Address - Street 1:820 TOWN CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1785
Mailing Address - Country:US
Mailing Address - Phone:215-499-4659
Mailing Address - Fax:267-212-5001
Practice Address - Street 1:317 W GERMANTOWN PIKE
Practice Address - Street 2:
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19403-4227
Practice Address - Country:US
Practice Address - Phone:215-499-4659
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA206640362OtherJEN SS #