Provider Demographics
NPI:1841438264
Name:THE POTTSVILLE PA ENDOSCOPY ASC, LLP (CRNA)
Entity type:Organization
Organization Name:THE POTTSVILLE PA ENDOSCOPY ASC, LLP (CRNA)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ARMIT
Authorized Official - Middle Name:P
Authorized Official - Last Name:NARULA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-346-7797
Mailing Address - Street 1:PO BOX 390
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18501-0390
Mailing Address - Country:US
Mailing Address - Phone:570-346-7797
Mailing Address - Fax:770-666-9078
Practice Address - Street 1:48 TUNNEL RD
Practice Address - Street 2:STE 103
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-3875
Practice Address - Country:US
Practice Address - Phone:570-622-6520
Practice Address - Fax:570-622-6525
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE POTTSVILLE PA ENDOSCOPY ASC, LLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1008496700001Medicaid
PA1008496700001Medicaid