Provider Demographics
NPI:1710252796
Name:MOUNTAINVIEW SURGICAL SERVICES
Entity Type:Organization
Organization Name:MOUNTAINVIEW SURGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-394-6029
Mailing Address - Street 1:PO BOX 8500-7422
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0001
Mailing Address - Country:US
Mailing Address - Phone:609-815-7810
Mailing Address - Fax:
Practice Address - Street 1:850 BEAR TAVERN RD
Practice Address - Street 2:SUITE 309
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08628-1018
Practice Address - Country:US
Practice Address - Phone:609-392-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-09
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty