Provider Demographics
NPI:1356321293
Name:THE SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:THE SURGERY CENTER, LLC
Other - Org Name:THE SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:LAPLANTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-241-2234
Mailing Address - Street 1:1440 HIGHWAY DRIVE
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36203
Mailing Address - Country:US
Mailing Address - Phone:256-241-2230
Mailing Address - Fax:256-241-2235
Practice Address - Street 1:1440 HIGHWAY DRIVE
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:AL
Practice Address - Zip Code:36203
Practice Address - Country:US
Practice Address - Phone:256-241-2230
Practice Address - Fax:256-241-2235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-18
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALASC0059CMedicaid
AL012499OtherBC
AL012499OtherBC
AL490004552Medicare PIN