Organization
SURGICAL SPECIALTY CENTER OF NORTHEASTERN PENNSYLVANIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY SNODGRASS (PRESIDENT)
(615) 665-1283
Entity
Organization
Contact information
Practice address
190 WELLES ST, FORTY FORT, PA 18704-4968
(570) 331-7615
(570) 331-7614
Mailing address
1A BURTON HILLS BLVD # L&C, NASHVILLE, TN 37215-6187
(615) 240-3820
(615) 234-1720
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
148601
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018825790001
—
PA
01
—
0198
FREEDOM BLUE
PA
01
—
077861
AMERIHEALTH PROVIDER #
PA
01
—
127866
MED PLUS/3 RIVERS PROVIDE
PA
01
—
2139542
UNITED HEALTHCARE
PA
01
—
2670019
AETNA PROVIDER NUMBER
PA
01
—
49005260
MEDICARE RAILROAD
PA
01
—
68929
GEISINGER PROVIDER #
PA
01
—
814135
FIRST PRIORITY HEALTH PRO
PA
01
—
991073
BLUE CROSS PROVIDER #
PA
01
—
A2738987
OXFORD PROVIDER #
PA
01
—
IY0345
HEALTH NET PROVIDER #
PA
Enumeration date
05/23/2005
Last updated
12/14/2022
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