Provider Demographics
NPI:1467691014
Name:BETHLEHEM ENDOSCOPY CENTER LLC
Entity Type:Organization
Organization Name:BETHLEHEM ENDOSCOPY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOURNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-866-5008
Mailing Address - Street 1:5325 NORTHGATE DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-9411
Mailing Address - Country:US
Mailing Address - Phone:610-866-5008
Mailing Address - Fax:610-866-6008
Practice Address - Street 1:5325 NORTHGATE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-9411
Practice Address - Country:US
Practice Address - Phone:610-866-5008
Practice Address - Fax:610-866-6008
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BETHLEHEM ENDOSCOPY CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-05
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA15601501261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA060604Medicare PIN