Provider Demographics
NPI:1720388465
Name:WEST ASC, LLC
Entity Type:Organization
Organization Name:WEST ASC, LLC
Other - Org Name:CAMILLUS SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FOODY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-701-9378
Mailing Address - Street 1:5700 W GENESEE ST
Mailing Address - Street 2:SUITE 11
Mailing Address - City:CAMILLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13031-3200
Mailing Address - Country:US
Mailing Address - Phone:315-701-9378
Mailing Address - Fax:315-701-0869
Practice Address - Street 1:5700 W GENESEE ST
Practice Address - Street 2:SUITE 11
Practice Address - City:CAMILLUS
Practice Address - State:NY
Practice Address - Zip Code:13031-3200
Practice Address - Country:US
Practice Address - Phone:315-701-9378
Practice Address - Fax:315-701-0869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical