Provider Demographics
NPI:1831637875
Name:UCSC LLC
Entity Type:Organization
Organization Name:UCSC LLC
Other - Org Name:UNION CITY SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JUSTINE
Authorized Official - Middle Name:B
Authorized Official - Last Name:CORDAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-714-3093
Mailing Address - Street 1:1722 E REELFOOT AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:UNION CITY
Mailing Address - State:TN
Mailing Address - Zip Code:38261-6050
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1722 E REELFOOT AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:UNION CITY
Practice Address - State:TN
Practice Address - Zip Code:38261-6050
Practice Address - Country:US
Practice Address - Phone:731-885-8484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-10
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical