Provider Demographics
NPI:1477514032
Name:THE HAND AMBULATORY SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:THE HAND AMBULATORY SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:MONTGOMERY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:513-961-7740
Mailing Address - Street 1:538 OAK ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2507
Mailing Address - Country:US
Mailing Address - Phone:513-961-7740
Mailing Address - Fax:513-961-7742
Practice Address - Street 1:538 OAK ST
Practice Address - Street 2:SUITE 100
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2507
Practice Address - Country:US
Practice Address - Phone:513-961-7740
Practice Address - Fax:513-961-7742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-31
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0510AS261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2103968Medicaid
OH2103968Medicaid