Provider Demographics
NPI:1346865078
Name:PANHANDLE OUTPATIENT SURGERY CENTER
Entity Type:Organization
Organization Name:PANHANDLE OUTPATIENT SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:KLUESNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-540-6455
Mailing Address - Street 1:1502 CREIGHTON RD STE C
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-7143
Mailing Address - Country:US
Mailing Address - Phone:850-876-8200
Mailing Address - Fax:
Practice Address - Street 1:1502 CREIGHTON RD STE C
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-7143
Practice Address - Country:US
Practice Address - Phone:561-630-6277
Practice Address - Fax:561-630-6062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-09
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical