Provider Demographics
NPI:1689251720
Name:MASON CITY AMBULATORY SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:MASON CITY AMBULATORY SURGERY CENTER, LLC
Other - Org Name:MASON CITY SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:RIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:641-494-2000
Mailing Address - Street 1:990 4TH ST SW
Mailing Address - Street 2:
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-2861
Mailing Address - Country:US
Mailing Address - Phone:641-494-2000
Mailing Address - Fax:641-494-2018
Practice Address - Street 1:990 4TH ST SW
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-2861
Practice Address - Country:US
Practice Address - Phone:641-494-2000
Practice Address - Fax:641-494-2018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-25
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty