Basic Information
| Provider Information | |||||||||
| NPI: | 1710987318 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHS AMBULATORY SURGERY CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2310 HIGHLAND AVE | ||||||||
| Address2: | |||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180208920 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6106914300 | ||||||||
| FaxNumber: | 6106916257 | ||||||||
| Practice Location | |||||||||
| Address1: | 2310 HIGHLAND AVE | ||||||||
| Address2: | |||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180208920 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6106914300 | ||||||||
| FaxNumber: | 6106916257 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2005 | ||||||||
| LastUpdateDate: | 12/07/2007 | ||||||||
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| AuthorizedOfficialLastName: | DIIORIO | ||||||||
| AuthorizedOfficialFirstName: | EMIL | ||||||||
| AuthorizedOfficialMiddleName: | JOHN | ||||||||
| AuthorizedOfficialTitleorPosition: | MEDICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 6108618080 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | 10371500 | PA | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.