Organization
WEST SHORE ENDOSCOPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK W JACKSON MD (PRESIDENT)
(717) 975-2430
Entity
Organization
Contact information
Practice address
423 N 21ST ST, SUITE 102, CAMP HILL, PA 17011-2207
(717) 975-2430
(717) 730-2158
Mailing address
423 N 21ST ST, SUITE 102, CAMP HILL, PA 17011-2207
(717) 975-2430
(717) 730-2158
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
05401500
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018652640002
—
PA
Enumeration date
07/15/2005
Last updated
10/22/2007
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