Organization
RIVER DRIVE SURGERY CENTER, LLC
Active
Other names
River Drive Surgery and Laser Center
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY E. SNODGRASS (PRESIDENT)
(615) 665-1283
Entity
Organization
Contact information
Practice address
619 RIVER DR FL 1, ELMWOOD PARK, NJ 07407-1317
(201) 703-2900
(201) 703-5246
Mailing address
1A BURTON HILLS BLVD STE 300, NASHVILLE, TN 37215-6153
(615) 240-3741
(615) 234-1720
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
22631
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0003895000
AMERIHEALTH
—
01
—
006973
EMPIRE BLUE YLD YLK YLA
—
01
—
01000333400
AMERICHOICE 9/1/01
—
01
—
0103113
GHI NON PAR
—
01
—
2225369
AETNA USHC
—
01
—
51842
AMERIGROUP VSP 10/25/01
—
05
—
8027706
—
NJ
Enumeration date
06/04/2006
Last updated
11/12/2025
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