Provider Demographics
NPI:1528016789
Name:HAMILTON SURGERY CENTER L.L.C.
Entity Type:Organization
Organization Name:HAMILTON SURGERY CENTER L.L.C.
Other - Org Name:SURGER CENTER AT HAMILTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:S
Authorized Official - Last Name:WETZEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-689-4820
Mailing Address - Street 1:1445 WHITEHORSE MERCERVILLE ROAD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619
Mailing Address - Country:US
Mailing Address - Phone:609-689-4820
Mailing Address - Fax:609-689-4821
Practice Address - Street 1:1445 WHITEHORSE MERCERVILLE ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619
Practice Address - Country:US
Practice Address - Phone:609-689-4820
Practice Address - Fax:609-689-4821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ23393261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0075612Medicaid
001353OtherHORIZON BCBS
NJ0075612Medicaid