Provider Demographics
NPI:1295817435
Name:WILLS SURGERY CENTER OF CHERRY HILL
Entity Type:Organization
Organization Name:WILLS SURGERY CENTER OF CHERRY HILL
Other - Org Name:SURGERY CENTER OF CHERY HILL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:P
Authorized Official - Last Name:BILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-440-3152
Mailing Address - Street 1:408 MARLTON PIKE E
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-2409
Mailing Address - Country:US
Mailing Address - Phone:856-354-1600
Mailing Address - Fax:856-429-7555
Practice Address - Street 1:408 MARLTON PIKE E
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2409
Practice Address - Country:US
Practice Address - Phone:856-354-1600
Practice Address - Fax:856-429-7555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ10287261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ10287OtherLICENSE #
NJ1016702OtherHORIZON MERCY PROVIDER #
NJ526637OtherAETNA/USHC PROVIDER #
NJ0001375000OtherAMERIHEALTH PROVIDER #
NJ490002850OtherMEDICARE RAILROAD PROVIDE
NJ6735100Medicaid
NJ311070Medicare ID - Type UnspecifiedPROVIDER ID NUMBER