Provider Demographics
NPI:1235480476
Name:FORT SUTTER SURGERY CENTER
Entity Type:Organization
Organization Name:FORT SUTTER SURGERY CENTER
Other - Org Name:SUTTER RIVER CITY SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-286-8202
Mailing Address - Street 1:2801 K ST
Mailing Address - Street 2:SUITE 525
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-5120
Mailing Address - Country:US
Mailing Address - Phone:916-733-5017
Mailing Address - Fax:916-733-8738
Practice Address - Street 1:75 SCRIPPS DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6320
Practice Address - Country:US
Practice Address - Phone:916-929-9431
Practice Address - Fax:916-929-0132
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FORT SUTTER SURGERY CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-27
Last Update Date:2012-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical