Organization
LEBANON OUTPATIENT SURGICAL CENTER L.P.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANITA G. FUHRMAN RN,BS,CASC (DIRECTOR)
(717) 228-1620
Entity
Organization
Contact information
Practice address
830 TUCK ST, LEBANON, PA 17042-7477
(717) 228-1620
(717) 228-1642
Mailing address
830 TUCK ST, LEBANON, PA 17042-7477
(717) 228-1620
(717) 228-1642
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
05781500
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001449984001
—
PA
01
—
1519405
GATEWAY HEALTH PLAN
PA
01
—
1600
HIGHMARK BLUE SHIELD
PA
01
—
390708
BLUE CROSS
PA
01
—
501572
AETNA
PA
01
—
718200
HEALTH AMERICAHEALTH ASSU
PA
Enumeration date
04/10/2006
Last updated
08/22/2020
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