Provider Demographics
NPI:1073601746
Name:LOWCOUNTRY SURGERY CENTER
Entity Type:Organization
Organization Name:LOWCOUNTRY SURGERY CENTER
Other - Org Name:ROPER WEST ASHLEY SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OFFICE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-763-3763
Mailing Address - Street 1:18 FARMFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-7704
Mailing Address - Country:US
Mailing Address - Phone:843-763-3763
Mailing Address - Fax:843-763-3881
Practice Address - Street 1:18 FARMFIELD AVE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-7704
Practice Address - Country:US
Practice Address - Phone:843-763-3763
Practice Address - Fax:843-763-3881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCASF-049261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC410102Medicaid
SC490000838OtherRAILROAD MEDICARE
SC410102Medicaid