# KEYSTONE SURGERY CENTER, LTD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679544290
- **Authorized official:** DR. ROBERT MONROE KIMMEL M.D., FACS (CEO/MEDICAL DIRECTOR)
- **Authorized official phone:** (570) 622-1200

## Contact information

- **Practice address:** 575 E NORWEGIAN ST, POTTSVILLE, PA 17901-3711
- **Practice address phone:** (570) 622-1200
- **Practice address fax:** (570) 622-7787
- **Mailing address:** 575 E NORWEGIAN ST, POTTSVILLE, PA 17901-3711
- **Mailing address phone:** (570) 622-1200
- **Mailing address fax:** (570) 622-7787

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 16671501 | PA | Yes |

## Other

- **Enumeration date:** 01/31/2006
- **Last updated:** 01/22/2009