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WILLS SURGERY CENTER OF THE NORTHEAST NPI 1629153770


NPI Information

NPI: 1629153770
Provider Name: WILLS SURGERY CENTER OF THE NORTHEAST
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 39D0907720

Address:
8400 ROOSEVELT BLVD
PHILADELPHIA, PA
ZIP 19152
Phone: (215) 332-7500
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WILLS SURGERY CENTER OF THE NORTHEAST is an ambulatory surgical clinic center in Philadelphia, PA. WILLS SURGERY CENTER OF THE NORTHEAST NPI is 1629153770. The provider is registered as an organization entity type.

The provider's business location address is:

8400 ROOSEVELT BLVD
PHILADELPHIA, PA
ZIP 19152-012
Phone: (215) 332-7500
Fax: (215) 332-7501

The provider's authorized official is Lana Serper .
The authorized official title is Business Office Manager and has the following contact phone number (215) 332-7500.

The CLIA number assigned to this NPI record is 39D0907720 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/26/2006 and was last updated on 1/9/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QA1903XClinic/CenterAmbulatory Surgical29821500PENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10015764400002MEDICAIDPENNSYLVANIA
2391056MEDICARE ID-TYPE UNSPECIFIEDPENNSYLVANIAPROVIDER NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.