Provider Demographics
NPI:1659463669
Name:ARUSHA LLC
Entity Type:Organization
Organization Name:ARUSHA LLC
Other - Org Name:THE SURGERY CENTER OF CHESTER COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PROVIDER ENROLLMENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-892-9813
Mailing Address - Street 1:460 CREAMERY WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2533
Mailing Address - Country:US
Mailing Address - Phone:610-594-8900
Mailing Address - Fax:610-594-8707
Practice Address - Street 1:460 CREAMERY WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2533
Practice Address - Country:US
Practice Address - Phone:610-594-8900
Practice Address - Fax:610-594-8707
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARUSHA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-28
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA02781500261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA050211Medicare ID - Type Unspecified