Provider Demographics
NPI:1063854628
Name:OUTPATIENT PROCEDURE CENTERS, LLC
Entity Type:Organization
Organization Name:OUTPATIENT PROCEDURE CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GANESH
Authorized Official - Middle Name:R
Authorized Official - Last Name:BALU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-741-0111
Mailing Address - Street 1:390 MITCH RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19804-3943
Mailing Address - Country:US
Mailing Address - Phone:302-741-0111
Mailing Address - Fax:302-741-0112
Practice Address - Street 1:240 BEISER BLVD
Practice Address - Street 2:SUITE #201 G
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-8208
Practice Address - Country:US
Practice Address - Phone:302-741-0111
Practice Address - Fax:302-741-0112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-24
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain