Provider Demographics
NPI: | 1922056878 |
---|---|
Name: | SOMERSET SURGERY CENTER LIMITED PARTNERSHIP |
Entity Type: | Organization |
Organization Name: | SOMERSET SURGERY CENTER LIMITED PARTNERSHIP |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | VP/SECRETARY |
Authorized Official - Prefix: | |
Authorized Official - First Name: | RICHARD |
Authorized Official - Middle Name: | L |
Authorized Official - Last Name: | SHARFF |
Authorized Official - Suffix: | JR |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 205-545-2572 |
Mailing Address - Street 1: | 30 MEDPARK DR |
Mailing Address - Street 2: | |
Mailing Address - City: | SOMERSET |
Mailing Address - State: | KY |
Mailing Address - Zip Code: | 42503-2797 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 30 MEDPARK DR |
Practice Address - Street 2: | |
Practice Address - City: | SOMERSET |
Practice Address - State: | KY |
Practice Address - Zip Code: | 42503-2797 |
Practice Address - Country: | US |
Practice Address - Phone: | 606-679-9322 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-05-04 |
Last Update Date: | 2009-06-01 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QA1903X | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
KY | ASC1008 | Medicare PIN |