Provider Demographics
NPI:1275577686
Name:P & S SURGERY CENTER LLC
Entity Type:Organization
Organization Name:P & S SURGERY CENTER LLC
Other - Org Name:P & S SURGICAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT, CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-998-6141
Mailing Address - Street 1:PO BOX 53575
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70505-3575
Mailing Address - Country:US
Mailing Address - Phone:318-998-6141
Mailing Address - Fax:318-998-6139
Practice Address - Street 1:312 GRAMMONT ST
Practice Address - Street 2:SUITE 101
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-7457
Practice Address - Country:US
Practice Address - Phone:318-998-6141
Practice Address - Fax:318-998-6139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA490282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1506753Medicaid
LA1506753Medicaid