Provider Demographics
NPI:1457490872
Name:HSC SURGICAL ASSOCIATES
Entity Type:Organization
Organization Name:HSC SURGICAL ASSOCIATES
Other - Org Name:FAIRFIELD ENDOSCOPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BOARD MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:V
Authorized Official - Last Name:SAFDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-751-6667
Mailing Address - Street 1:2990 MACK RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-5383
Mailing Address - Country:US
Mailing Address - Phone:513-874-9432
Mailing Address - Fax:
Practice Address - Street 1:2990 MACK RD
Practice Address - Street 2:SUITE 203
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-5383
Practice Address - Country:US
Practice Address - Phone:513-874-9432
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0776AS261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0980827Medicaid
OH3612051Medicare ID - Type UnspecifiedMEDICARE NUMBER