Organization
THE SURGERY CENTER AT BRINTON LAKE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM HAUSER M.D. (MEDICAL DOCTOR)
(484) 846-5100
Entity
Organization
Contact information
Practice address
300 EVERGREEN DRIVE, SUITE 320, GLEN MILLS, PA 19342
(484) 846-5100
(484) 846-5101
Mailing address
300 EVERGREEN DRIVE, SUITE 320, GLEN MILLS, PA 19342
(484) 846-5100
(484) 846-5101
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
1884
PA
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
18841501
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005102000
INDEPENDENCE BLUE CROSS
PA
05
—
1015885230001
—
PA
Enumeration date
06/13/2006
Last updated
04/15/2009
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