Organization
WYOMISSING SURGICAL SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON THOMAS BUNDY M.D. (MEDICAL DIRECTOR)
(610) 373-3715
Entity
Organization
Contact information
Practice address
1235 PENN AVE, SUITE 100, WYOMISSING, PA 19610-2100
(610) 373-3715
(610) 373-3164
Mailing address
1235 PENN AVE, SUITE 100, WYOMISSING, PA 19610-2100
(610) 373-3715
(610) 373-3164
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
16691501
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104918000
FEDERAL WORKER'S COMP
PA
01
—
1869
HIGHMARK BLUE SHIELD
PA
01
—
2072
INDEPENDENCE BLUE CROSS
PA
01
—
231648
HEALTHAMERICA
PA
01
—
390850
CAPITAL BLUE CROSS
PA
Enumeration date
07/07/2005
Last updated
07/27/2016
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