Provider Demographics
NPI:1710336763
Name:MT PLEASANT SURGERY CENTER LLC
Entity Type:Organization
Organization Name:MT PLEASANT SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:OESTRIKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-546-2164
Mailing Address - Street 1:4851 E PICKARD ST
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-2078
Mailing Address - Country:US
Mailing Address - Phone:231-499-1159
Mailing Address - Fax:
Practice Address - Street 1:4851 E PICKARD ST
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-2078
Practice Address - Country:US
Practice Address - Phone:231-499-1159
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-10
Last Update Date:2017-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical