STADIUM CAMPUS AMBULATORY SURGICAL CENTER, LLC (NPI# 1679658710) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679658710 |
| Entity Type | Organization |
| Organization Name | STADIUM CAMPUS AMBULATORY SURGICAL CENTER, LLC |
| Other Organization Name | WILLS EYE SURGERY CENTER |
| Practice Address |
3340 S Broad St Philadelphia PA 19145-5802 |
| Practice Telephone | 2154631900 |
| Mailing Telephone | 2154631900 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. JOSEPH BILSON (PRESIDENT) |
| Authorized Official Telephone | 2154403152 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
11381500 | PA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 0017912500002 | 05 |
| Other Name | Type Code |
|---|---|
| Wills Eye Surgery Center | Doing Business As Name - Organization |
| Street Address |
3340 S BROAD ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19145-5802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518564350 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 2300a Rear W Oregon Ave, Philadelphia, PA 19145 | 2020-10-05 |
| 1376069559 | Kyle James Hughes | Physical Therapist | 2192 W Oregon Ave Fl 3, Philadelphia, PA 19145 | 2017-08-18 |
| 1821519752 | John A Takacs Dmd | Clinic/Center | 1707w Passyunk Ave, Philadelphia, PA 19145 | 2017-06-30 |
| 1033573209 | Kenneth Donahue | Dentist | 1517 Packer Avenue, Philadelphia, PA 19145 | 2016-04-13 |
| 1437516895 | Kimberly Wyand | Physical Therapist | 2129 Oregon St, Philadelphia, PA 19145 | 2016-01-15 |
| 1760856538 | Liji Vipin | Nurse Practitioner | 1615 Oregon Ave, Philadelphia, PA 19145 | 2015-11-17 |
| 1528333846 | Gina Marie Doyle | Registered Nurse | 1930 S. Broad Street, Philadelphia, PA 19145 | 2012-03-20 |
| 1639446214 | Thao T Tran | Pharmacist | 2014-24 South Broad St, Philadelphia, PA 19145 | 2011-11-25 |
| 1649573171 | Phyllis Yang | Internal Medicine | 1700 S Broad St, Unit 201, Philadelphia, PA 19145 | 2010-12-05 |
| 1326364613 | South Philadelphia Open Mri, LLC | Clinic/Center | 1834 West Oregon Avenue, Philadelphia, PA 19145 | 2010-04-13 |
| Find all providers in zip 19145 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154839553 | American Access Care of Sp LLC | Clinic/Center | 2412 W Passyunk Ave # 14, Philadelphia, PA 19145-4114 | 2018-01-19 |
| 1265950802 | M&m Surgical Center PC | Clinic/Center | 1 Crescent Dr. Suite 300, Philadelphia, PA 19112 | 2017-09-05 |
| 1154787117 | The Pennsylvania Surgery and Laser Center LLC | Clinic/Center | 601 Franklin Mills Cir, Philadelphia, PA 19154-3124 | 2016-01-06 |
| 1023347226 | The Children's Hospital of Philadelphia | Clinic/Center | 34th & Civic Center Ave, Philadelphia, PA 19104 | 2009-12-17 |
| 1710114293 | Riverview Surgery Center At The Navy Yard Lp | Clinic/Center | Three Crescent Drive, Navy Yard Corporate Center, Philadelphia, PA 19112 | 2009-06-11 |
| 1083750103 | Perry Black | Clinic/Center | 219 N Broad St Fl -10th, Philadelphia, PA 19107-1519 | 2007-01-29 |
| 1447301122 | Planned Parenthood Southeastern Pennsylvania | Clinic/Center | 1144 Locust St, Philadelphia, PA 19107-6734 | 2007-01-16 |
| 1215038252 | Red Lion Surgicenter, LLC | Clinic/Center | 240 Geiger Rd, Philadelphia, PA 19115-1008 | 2006-09-25 |
| 1447218433 | Liberty Eye Surgical Center LLC | Clinic/Center | 9122 Blue Grass Rd, Philadelphia, PA 19114-3202 | 2006-05-02 |
| 1386646891 | Temple University of The Commonwealth System of Higher Education | Clinic/Center | 8th At Race Street, Second Floor, Philadelphia, PW 19107-0000 | 2005-08-15 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19145 |
Please comment or provide details below to improve the information on STADIUM CAMPUS AMBULATORY SURGICAL CENTER, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.