Provider Demographics
NPI:1003842527
Name:SUMMIT SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:SUMMIT SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-809-1997
Mailing Address - Street 1:7015 HWY 190 E SERV RD
Mailing Address - Street 2:101B
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-4960
Mailing Address - Country:US
Mailing Address - Phone:985-893-9366
Mailing Address - Fax:985-809-1664
Practice Address - Street 1:7015 HWY 190 E SERV RD
Practice Address - Street 2:101B
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-4960
Practice Address - Country:US
Practice Address - Phone:985-893-9366
Practice Address - Fax:985-809-1664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA136261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1335398Medicaid
LA1335398Medicaid