Organization
JOHNSON HEALTH CARE, INC. DBA JOHNSON SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY VALENTE (VICE PRESIDENT)
(860) 763-7667
Entity
Organization
Contact information
Practice address
148 HAZARD AVE, ENFIELD, CT 06082-4520
(860) 763-7650
Mailing address
24 BATTLE ST, P.O. BOX 750, SOMERS, CT 06071-1629
(860) 684-8417
(860) 684-8420
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0066
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
122
ANTHEM BC/BS PROVIDER NUM
CT
01
—
775436
CONNECTICARE PROVIDER NUM
CT
01
—
A487059
OXFORD PROVIDER NUMBER
CT
01
—
IR0098
HEALTH NET PROVIDER NUMBE
CT
Enumeration date
07/05/2005
Last updated
08/22/2020
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