Organization
SURGERY CENTER OF LEBANON, LP
Active
Other names
PHYSICIANS SURGICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BOYD BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
(615) 234-5954
Entity
Organization
Contact information
Practice address
1840 QUENTIN RD, LEBANON, PA 17042-7436
(717) 272-0007
(717) 675-2247
Mailing address
1840 QUENTIN RD, LEBANON, PA 17042-7436
(717) 272-0007
(717) 675-2247
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1893
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101425401
—
PA
01
—
1893
DOH LICENSURE NUMBER
PA
Enumeration date
07/25/2006
Last updated
03/07/2023
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