Provider Demographics
NPI:1134499684
Name:CHILDRENS SURGERY CENTER OF MALVERN, LLC
Entity Type:Organization
Organization Name:CHILDRENS SURGERY CENTER OF MALVERN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ESPENSCHIED
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, CNOR
Authorized Official - Phone:610-518-4937
Mailing Address - Street 1:482 WATERWAY RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19363-2417
Mailing Address - Country:US
Mailing Address - Phone:610-518-4937
Mailing Address - Fax:610-514-9536
Practice Address - Street 1:596 LANCASTER AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-1808
Practice Address - Country:US
Practice Address - Phone:610-518-4937
Practice Address - Fax:610-514-9536
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHILDRENS SURGERY CENTER, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-12-30
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical