Provider Demographics
NPI:1831117704
Name:MEDICAL HEIGHTS SURGERY CENTER, INC.
Entity Type:Organization
Organization Name:MEDICAL HEIGHTS SURGERY CENTER, INC.
Other - Org Name:KENTUCKY SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZARTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-278-1460
Mailing Address - Street 1:240 FOUNTAIN CT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1888
Mailing Address - Country:US
Mailing Address - Phone:859-278-1460
Mailing Address - Fax:859-278-0115
Practice Address - Street 1:240 FOUNTAIN CT
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1888
Practice Address - Country:US
Practice Address - Phone:859-278-1460
Practice Address - Fax:859-278-0115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY300068261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY054826OtherANTHEM PROVIDER NO
KY36000248Medicaid
KY054826OtherANTHEM PROVIDER ID
KYASC1014Medicare PIN