Provider Demographics
NPI:1598530578
Name:BEACON WEST SURGERY CENTER LLC
Entity Type:Organization
Organization Name:BEACON WEST SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TURENTINE
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:816-786-4901
Mailing Address - Street 1:11340 NALL AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1234
Mailing Address - Country:US
Mailing Address - Phone:816-579-1500
Mailing Address - Fax:
Practice Address - Street 1:11340 NALL AVENUE
Practice Address - Street 2:SUITE 100
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211
Practice Address - Country:US
Practice Address - Phone:816-786-4901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical