Provider Demographics
NPI:1821528753
Name:KENNEDY CHERRY HILL SURGICAL CENTER LLC
Entity Type:Organization
Organization Name:KENNEDY CHERRY HILL SURGICAL CENTER LLC
Other - Org Name:JEFFERSON SURGERY CENTER - CHERRY HILL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE CHAIR, NUEHEALTH
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:TASSET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-647-6475
Mailing Address - Street 1:11250 TOMAHAWK CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-2668
Mailing Address - Country:US
Mailing Address - Phone:913-647-6475
Mailing Address - Fax:
Practice Address - Street 1:2211 CHAPEL AVE W STE 200
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-2048
Practice Address - Country:US
Practice Address - Phone:856-295-9041
Practice Address - Fax:856-295-9042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-13
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical