Provider Demographics
NPI:1669446852
Name:VOORHEES NJ ENDOSCOPY ASC LLC
Entity Type:Organization
Organization Name:VOORHEES NJ ENDOSCOPY ASC LLC
Other - Org Name:THE ENDO CENTER AT VOORHEES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:E
Authorized Official - Last Name:SNODGRASS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-665-1283
Mailing Address - Street 1:1A BURTON HILLS BLVD
Mailing Address - Street 2:ATTN: L&C
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6103
Mailing Address - Country:US
Mailing Address - Phone:856-770-1920
Mailing Address - Fax:856-770-1925
Practice Address - Street 1:93 COOPER RD
Practice Address - Street 2:SUITE 101
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4910
Practice Address - Country:US
Practice Address - Phone:856-770-1920
Practice Address - Fax:856-770-1925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-14
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ24436261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8536404Medicaid
NJ8536404Medicaid
NJ490004984Medicare PIN
NJ31C0001132Medicare Oscar/Certification