Provider Demographics
NPI:1164490728
Name:THE READING HOSPITAL SURGICENTER AT SPRING RIDGE LLC
Entity Type:Organization
Organization Name:THE READING HOSPITAL SURGICENTER AT SPRING RIDGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:ERTEL
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, CNOR, RNFA,
Authorized Official - Phone:484-628-3050
Mailing Address - Street 1:2603 KEISER BLVD
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-3341
Mailing Address - Country:US
Mailing Address - Phone:484-628-3050
Mailing Address - Fax:484-628-3020
Practice Address - Street 1:2603 KEISER BLVD
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-3341
Practice Address - Country:US
Practice Address - Phone:610-568-3050
Practice Address - Fax:610-568-3020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-09
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA16481501261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
168724OtherUNISON
13011OtherHEALTH GUARD
6929779OtherCIGNA
0001391000OtherINDEPENDENCE BC
0390857OtherKEYSTONE HEALTH PLAN CENT
001391OtherKEYSTONE EAST
30023577OtherKEYSTONE MERCY HEALTH PLA
PA0247OtherHIGHMARK BLUE SHIELD
C99480OtherAMERIHEALTH ADMINISTRATOR
PA1012727600001Medicaid
PA390857OtherCAPITAL BLUE CROSS
PA7309604OtherAETNA
PA1012727600001Medicaid