Provider Demographics
NPI:1134125719
Name:SURGICAL CENTER OF YORK, INC
Entity Type:Organization
Organization Name:SURGICAL CENTER OF YORK, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE SERVICES MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:ELEANORE
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-849-5676
Mailing Address - Street 1:1750 5TH AVE
Mailing Address - Street 2:FL 1
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-2610
Mailing Address - Country:US
Mailing Address - Phone:717-843-7613
Mailing Address - Fax:717-849-5662
Practice Address - Street 1:1750 5TH AVE
Practice Address - Street 2:FL 1
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-2610
Practice Address - Country:US
Practice Address - Phone:717-843-7613
Practice Address - Fax:717-849-5662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA45681500261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011565990002Medicaid
PA390705OtherBLUE CROSS
PA1760OtherBLUE SHIELD
PA391028Medicare ID - Type Unspecified