Provider Demographics
NPI:1306486634
Name:FREDERICKSBURG ENDOSCOPY CENTER, LLC
Entity type:Organization
Organization Name:FREDERICKSBURG ENDOSCOPY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:KAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-408-0800
Mailing Address - Street 1:1211 CENTRAL PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-4912
Mailing Address - Country:US
Mailing Address - Phone:540-408-0800
Mailing Address - Fax:540-408-0810
Practice Address - Street 1:1211 CENTRAL PARK BLVD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4912
Practice Address - Country:US
Practice Address - Phone:540-408-0800
Practice Address - Fax:540-408-0810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-15
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical