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Organization
QITA ASC-HARRISBURG, LLC
Active
Organization
QITA ASC-HARRISBURG, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BENJAMIN SLATER (CHIEF PRODUCT & STRATEGY OFFICER)
(717) 932-6343
Entity
Organization
Contact information
Practice address
815 SIR THOMAS CT, HARRISBURG, PA 17109-4839
(717) 938-2765
Mailing address
815 SIR THOMAS CT, HARRISBURG, PA 17109-4839
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
—
NULL
2085R0204X
Vascular & Interventional Radiology Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
261QR0200X
Radiology Clinic/Center
—
NULL
Other
Enumeration date
03/26/2020
Last updated
03/26/2020
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