Organization
PLYMOUTH MEETING AMBULATORY SURGICAL CENTER LLC
Active
Other names
Wills Eye Surgery Center of Plymouth Meeting
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VICTOR P KRZESINSKI RN (ADMINISTRATOR DIRECTOR OF NURSING)
(610) 834-9700
Entity
Organization
Contact information
Practice address
625 W RIDGE PIKE, BUILDING B, CONSHOHOCKEN, PA 19428-1180
(610) 834-9700
(610) 834-9992
Mailing address
625 W RIDGE PIKE, BUILDING B, CONSHOHOCKEN, PA 19428-1180
(610) 834-9700
(610) 834-9992
Taxonomy
Speciality
Code
Description
License number
State
261QS0132X
Ophthalmologic Surgery Clinic/Center
Primary
07451500
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001379000
BLUE CROSS PROVIDER NUMBE
PA
05
—
001639951003
—
PA
Enumeration date
09/20/2006
Last updated
02/10/2012
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