Provider Demographics
NPI:1558540922
Name:BEAVER VALLEY OFFICE BASED SURGERY LLC
Entity Type:Organization
Organization Name:BEAVER VALLEY OFFICE BASED SURGERY LLC
Other - Org Name:BEAVER VALLEY CENTER FOR SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:C
Authorized Official - Last Name:PAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-774-2177
Mailing Address - Street 1:3153 BRODHEAD RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:ALIQUIPPA
Mailing Address - State:PA
Mailing Address - Zip Code:15001-1370
Mailing Address - Country:US
Mailing Address - Phone:724-774-2177
Mailing Address - Fax:724-774-1998
Practice Address - Street 1:3153 BRODHEAD RD
Practice Address - Street 2:SUITE B
Practice Address - City:ALIQUIPPA
Practice Address - State:PA
Practice Address - Zip Code:15001-1370
Practice Address - Country:US
Practice Address - Phone:724-774-2177
Practice Address - Fax:724-774-1998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical