Provider Demographics
NPI:1881687614
Name:TURKS HEAD SURGERY CENTER LLC
Entity Type:Organization
Organization Name:TURKS HEAD SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:C
Authorized Official - Last Name:BALDASSARRE
Authorized Official - Suffix:
Authorized Official - Credentials:RT CPC
Authorized Official - Phone:484-723-0039
Mailing Address - Street 1:915 OLD FERN HILL RD
Mailing Address - Street 2:BLDG B SUITE 100
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-4269
Mailing Address - Country:US
Mailing Address - Phone:484-723-0100
Mailing Address - Fax:484-723-0030
Practice Address - Street 1:915 OLD FERN HILL RD
Practice Address - Street 2:BLDG B SUITE 100
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4269
Practice Address - Country:US
Practice Address - Phone:484-723-0100
Practice Address - Fax:484-723-0030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-26
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1865261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA39C0001187Medicare NSC
PA092397Medicare ID - Type UnspecifiedPROVIDER NUMBER