Organization Name:  JOHNSON HEALTH CARE, INC. DBA JOHNSON SURGERY CENTER


Practice Location:
148 HAZARD AVE  ENFIELD, CT 06082 US
Tel: 860-763-7650  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
Y	261QA1903X	Ambulatory Health Care Facilities Clinic/Center Ambulatory Surgical	CT	0066

Other Provider Identifiers:

Issuer	Number	State	Type
ANTHEM BC/BS PROVIDER NUM	122	CT	01
HEALTH NET PROVIDER NUMBE	IR0098	CT	01
CONNECTICARE PROVIDER NUM	775436	CT	01
OXFORD PROVIDER NUMBER	A487059	CT	01

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin