Provider Demographics
NPI:1982880274
Name:BURLINGTON COUNTY ENDOSCOPY CENTER LLC
Entity type:Organization
Organization Name:BURLINGTON COUNTY ENDOSCOPY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOHLFELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-589-9024
Mailing Address - Street 1:2500 YORK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:JAMISON
Mailing Address - State:PA
Mailing Address - Zip Code:18929-1098
Mailing Address - Country:US
Mailing Address - Phone:215-589-9024
Mailing Address - Fax:833-705-6301
Practice Address - Street 1:140 MOUNT HOLLY BY PASS
Practice Address - Street 2:UNIT 5
Practice Address - City:LUMBERTON
Practice Address - State:NJ
Practice Address - Zip Code:08048-1114
Practice Address - Country:US
Practice Address - Phone:609-267-1555
Practice Address - Fax:609-267-1556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
80032OtherAAAHC ACCREDITATION
NJ189561Medicaid
80032OtherAAAHC ACCREDITATION