Provider Demographics
NPI:1881644995
Name:DERRY SURGERY CENTER LP
Entity Type:Organization
Organization Name:DERRY SURGERY CENTER LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCIAL OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:FINNEGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-789-2808
Mailing Address - Street 1:6 TSIENNETO RD
Mailing Address - Street 2:101 LL
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-1584
Mailing Address - Country:US
Mailing Address - Phone:603-537-2060
Mailing Address - Fax:603-537-2062
Practice Address - Street 1:6 TSIENNETO RD
Practice Address - Street 2:101 LL
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-1584
Practice Address - Country:US
Practice Address - Phone:603-537-2060
Practice Address - Fax:603-537-2062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE301027Medicare PIN