Provider Demographics
NPI:1578608642
Name:SEAFORD ENDOSCOPY CENTER LLC
Entity Type:Organization
Organization Name:SEAFORD ENDOSCOPY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MACKLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:302-629-7177
Mailing Address - Street 1:924 MIDDLEFORD RD
Mailing Address - Street 2:SEAFORD ENDOSCOPY CENTER, LLC
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-3604
Mailing Address - Country:US
Mailing Address - Phone:302-629-2229
Mailing Address - Fax:302-629-2285
Practice Address - Street 1:13 FALLON AVE
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-1577
Practice Address - Country:US
Practice Address - Phone:302-629-2229
Practice Address - Fax:302-629-7677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy