Provider Demographics
NPI:1497406110
Name:CAMBRIDGE SURGICAL SUITES, LLC
Entity Type:Organization
Organization Name:CAMBRIDGE SURGICAL SUITES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:BEREND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-906-7207
Mailing Address - Street 1:61605 SOUTHGATE RD
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725-9114
Mailing Address - Country:US
Mailing Address - Phone:740-509-1818
Mailing Address - Fax:
Practice Address - Street 1:61605 SOUTHGATE RD
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-9114
Practice Address - Country:US
Practice Address - Phone:740-509-1818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-13
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical