LIBERTY EYE SURGICAL CENTER NPI 1649325713

NPI Information

NPI: 1649325713
Provider Name: LIBERTY EYE SURGICAL CENTER

Doing Business As: LIBERTY SURGICAL CENTER

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
9122 BLUE GRASS RD
PHILADELPHIA, PA
ZIP 19114
Phone: (215) 673-9231
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LIBERTY EYE SURGICAL CENTER is an ambulatory surgical clinic center in Philadelphia, PA. LIBERTY EYE SURGICAL CENTER NPI is 1649325713. The provider is registered as an organization entity type.
The provider Is Doing Business As Liberty Surgical Center.

The provider's business location address is:

9122 BLUE GRASS RD
PHILADELPHIA, PA
ZIP 19114-202
Phone: (215) 673-9231
Fax: (215) 673-9236

The provider's authorized official is Edward Michael Quinn .
The authorized official title is Administrator and has the following contact phone number (215) 673-9231.

The enumeration date for this NPI number is 1/25/2007 and was last updated on 8/22/2020.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	17401501	PENNSYLVANIA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1009642060001	MEDICAID	PENNSYLVANIA

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

NPI Synchronization or Removal

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