Provider Demographics
NPI:1013412287
Name:BLUE BELL ASC, LLC
Entity Type:Organization
Organization Name:BLUE BELL ASC, LLC
Other - Org Name:JEFFERSON SURGERY CENTER - BLUE BELL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE CHAIR, NUEHEALTH
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:TASSET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-387-0510
Mailing Address - Street 1:11221 ROE AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1941
Mailing Address - Country:US
Mailing Address - Phone:913-387-0510
Mailing Address - Fax:
Practice Address - Street 1:518 EAST TOWNSHIP LINE RD STE 120
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422
Practice Address - Country:US
Practice Address - Phone:913-387-0510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-28
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical