Organization
SHORE AMBULATORY SURGICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARTHA MCKINLEY (BUSINESS MANAGER)
(609) 601-7601
Entity
Organization
Contact information
Practice address
405 BETHEL RD, SOMERS POINT, NJ 08244-2108
(609) 601-7601
(609) 601-7910
Mailing address
405 BETHEL RD, SOMERS POINT, NJ 08244-2108
(609) 601-7601
(609) 601-7910
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
22962
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000895000
AMERIHEALTH ID #
NJ
01
—
001090
HORIZON BC/BS OF NJ
NJ
05
—
1170735
—
NJ
01
—
A3199967
OXFORD HEALTH PLAN ID#
NJ
Enumeration date
04/05/2006
Last updated
08/22/2020
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