Organization
STADIUM CAMPUS AMBULATORY SURGICAL CENTER, LLC
Active
Other names
Wills Eye Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH BILSON (PRESIDENT)
(215) 440-3152
Entity
Organization
Contact information
Practice address
3340 S BROAD ST, PHILADELPHIA, PA 19145-5802
(215) 463-1900
Mailing address
3340 S BROAD ST, PHILADELPHIA, PA 19145-5802
(215) 463-1900
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
11381500
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017912500002
—
PA
Enumeration date
10/26/2006
Last updated
08/22/2020
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