Provider Demographics
NPI:1598786477
Name:OSTEOPATHIC SURGICAL CENTERS, LLC
Entity Type:Organization
Organization Name:OSTEOPATHIC SURGICAL CENTERS, LLC
Other - Org Name:CHARLOTTESVILLE SURGICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:H
Authorized Official - Last Name:DEAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:434-974-7200
Mailing Address - Street 1:2050 ABBEY RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-3553
Mailing Address - Country:US
Mailing Address - Phone:434-974-7200
Mailing Address - Fax:434-295-7039
Practice Address - Street 1:2050 ABBEY RD
Practice Address - Street 2:SUITE D
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-3553
Practice Address - Country:US
Practice Address - Phone:434-974-7200
Practice Address - Fax:434-295-7039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAOH705261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical