Provider Demographics
NPI:1821219718
Name:WASHINGTON SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:WASHINGTON SURGERY CENTER, LLC
Other - Org Name:WASHINGTON SURGERY CENTER, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:HOKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-239-9122
Mailing Address - Street 1:16 CHAMBER DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63090-5279
Mailing Address - Country:US
Mailing Address - Phone:636-239-9122
Mailing Address - Fax:636-239-9120
Practice Address - Street 1:16 CHAMBER DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090-5279
Practice Address - Country:US
Practice Address - Phone:636-239-9122
Practice Address - Fax:636-239-9120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO169-1261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical