Provider Demographics
NPI:1871811257
Name:HILLSIDE ENDOSCOPY CENTER, LLC
Entity type:Organization
Organization Name:HILLSIDE ENDOSCOPY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-633-9086
Mailing Address - Street 1:250 FAME AVE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-1587
Mailing Address - Country:US
Mailing Address - Phone:717-633-9086
Mailing Address - Fax:717-633-9379
Practice Address - Street 1:250 FAME AVE
Practice Address - Street 2:SUITE 240
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1587
Practice Address - Country:US
Practice Address - Phone:717-633-9086
Practice Address - Fax:717-633-9379
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HILLSIDE PROPERTY HOLDINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-05-11
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical