Provider Demographics
NPI:1760794218
Name:NSC MANAGEMENT COMPANY, INC.
Entity Type:Organization
Organization Name:NSC MANAGEMENT COMPANY, INC.
Other - Org Name:ENDEAVOR SURGICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:MORREALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-718-8450
Mailing Address - Street 1:8327 RESEDA BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-4620
Mailing Address - Country:US
Mailing Address - Phone:818-718-8450
Mailing Address - Fax:818-718-8456
Practice Address - Street 1:8327 RESEDA BLVD
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-4620
Practice Address - Country:US
Practice Address - Phone:818-718-8450
Practice Address - Fax:818-718-8456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-12
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF1413Medicare UPIN