Organization
MAIN LINE PA ENDOSCOPY ASC LP
Active
Other names
Main Line Endoscopy Center Bala Cynwyd
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY SNODGRASS (PRESIDENT)
(615) 665-1283
Entity
Organization
Contact information
Practice address
333 E CITY LINE AVE, TWO BALA PLAZA, SUITE 30, BALA CYNWYD, PA 19004-1501
(610) 644-7274
(610) 644-7276
Mailing address
1A BURTON HILLS BLVD # L&C, STE 300, NASHVILLE, TN 37215-6187
(615) 240-3820
(615) 234-1720
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
16701501
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00478537
RAILROAD MEDICARE
PA
Enumeration date
09/22/2006
Last updated
03/07/2024
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