Provider Demographics
NPI:1780649269
Name:MARIETTA SURGERY CENTER
Entity Type:Organization
Organization Name:MARIETTA SURGERY CENTER
Other - Org Name:FIRST SETTLEMENT ORTHOPAEDIC INSTITUTE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:RN ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-374-8596
Mailing Address - Street 1:611 SECOND STREET
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750
Mailing Address - Country:US
Mailing Address - Phone:740-374-8596
Mailing Address - Fax:740-374-9087
Practice Address - Street 1:611 SECOND STREET
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750
Practice Address - Country:US
Practice Address - Phone:740-374-8596
Practice Address - Fax:740-374-9087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1081684261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2192630Medicaid
WV1802153000Medicaid
WV1802153000Medicaid