Organization
PENN STATE HERSHEY ENDOSCOPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOEL HAIGHT MD (MEDICAL DIRECTOR)
(814) 272-4481
Entity
Organization
Contact information
Practice address
32 COLONNADE WAY, STATE COLLEGE, PA 16803-2309
(814) 272-4481
(814) 272-4470
Mailing address
32 COLONNADE WAY, STATE COLLEGE, PA 16803-2309
(814) 272-4481
(814) 272-4470
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
2287I501
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39C0001291
MEDICARE CCN
PA
Enumeration date
12/21/2010
Last updated
09/08/2011
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