Provider Demographics
NPI:1790213361
Name:NANTICOKE SURGICAL CENTER LLC
Entity Type:Organization
Organization Name:NANTICOKE SURGICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:DORAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:302-536-6094
Mailing Address - Street 1:400 HEALTH SERVICES DR
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-5769
Mailing Address - Country:US
Mailing Address - Phone:302-536-6094
Mailing Address - Fax:
Practice Address - Street 1:400 HEALTH SERVICES DR
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-5769
Practice Address - Country:US
Practice Address - Phone:302-536-6094
Practice Address - Fax:302-990-3081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-26
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical