Organization
EASTERN CONNECTICUT ENDOSCOPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY SNODGRASS (PRESIDENT)
(615) 665-1283
Entity
Organization
Contact information
Practice address
79 WAWECUS ST, SUITE 107, NORWICH, CT 06360-2160
(860) 886-7800
(860) 886-7808
Mailing address
1A BURTON HILLS BLVD # L&C, NASHVILLE, TN 37215-6187
(615) 240-3820
(615) 234-1720
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
261QE0800X
Endoscopy Clinic/Center
Primary
0295
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2373165
AETNA PHMO POS
—
01
—
351
BCBS FEDERAL
—
01
—
490004614
MEDICARE RAILROAD
CT
01
—
765560
CONNECTICARE
—
01
—
A2114853
OXFORD
—
01
—
IV9845
HEALTH NET
—
Enumeration date
10/11/2005
Last updated
08/09/2022
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