Provider Demographics
NPI:1326040668
Name:READING ENDOSCOPY CENTER, LLC
Entity Type:Organization
Organization Name:READING ENDOSCOPY CENTER, LLC
Other - Org Name:READING ENDOSCOPY CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICER, MEDICARE AUTHORIZED OFFICI
Authorized Official - Prefix:MR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-763-3859
Mailing Address - Street 1:1 GRANITE POINT DRIVE
Mailing Address - Street 2:SUITE 370
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1986
Mailing Address - Country:US
Mailing Address - Phone:610-685-5757
Mailing Address - Fax:610-685-5135
Practice Address - Street 1:1 GRANITE POINT DRIVE
Practice Address - Street 2:SUITE 370
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1986
Practice Address - Country:US
Practice Address - Phone:610-685-5757
Practice Address - Fax:610-685-5135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA17831501261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
090795Medicare PIN
39C0001182Medicare Oscar/Certification