# PINE GROVE AMBULATORY SURGICAL

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

## Provider details

- **NPI number:** 1689860124
- **Authorized official:** MRS. EMILEE S LANGER MPH (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (814) 688-0426

## Contact information

- **Practice address:** 10 TIMBERVIEW LANE, RUSSELL, PA 16345
- **Practice address phone:** (814) 757-5819
- **Practice address fax:** (814) 757-5829
- **Mailing address:** 10 TIMBERVIEW LANE, RUSSELL, PA 16345
- **Mailing address phone:** (814) 757-5819
- **Mailing address fax:** (814) 757-5829

## Taxonomy

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

## Other

- **Enumeration date:** 09/19/2007
- **Last updated:** 02/19/2008