Organization
DOVER OPHTHALMOLOGY ASC, LLC
Active
Other names
Blue Hen Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILLIP CLENDENIN (PRESIDENT)
(615) 665-1283
Entity
Organization
Contact information
Practice address
655 S BAY RD, SUITE 5B, DOVER, DE 19901-4615
(302) 678-4688
(302) 678-4625
Mailing address
20 BURTON HILLS BLVD., SUITE 500, ATTN: L&C, NASHVILLE, TN 37215-6176
(615) 665-1283
(615) 234-1720
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
FSSC-005
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001148628
—
DE
Enumeration date
02/09/2006
Last updated
09/07/2023
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