Provider Demographics
NPI:1346243680
Name:LAWRENCE SURGERY CENTER LLC
Entity Type:Organization
Organization Name:LAWRENCE SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEISA
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-832-0588
Mailing Address - Street 1:6265 ROCK CHALK DR
Mailing Address - Street 2:SUITE 2100
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-5232
Mailing Address - Country:US
Mailing Address - Phone:785-832-0588
Mailing Address - Fax:785-832-2029
Practice Address - Street 1:6265 ROCK CHALK DR
Practice Address - Street 2:STE 2100
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-5232
Practice Address - Country:US
Practice Address - Phone:785-832-0588
Practice Address - Fax:785-832-2029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-31
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSS023002261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS144083900OtherUS DEPT OF LABOR
KS1511OtherFEDERAL BCBS PROV. #
KS390320OtherFIRSTGUARD PROV. #
KS130326OtherBCBS KS PROV. #
KS100372910AMedicaid
KS90932017OtherBCBS KC PROV. #
KS490004711Medicare ID - Type UnspecifiedRAILROAD MEDICARE
KS144083900OtherUS DEPT OF LABOR