Provider Demographics
NPI:1922187103
Name:NORTH HILLS SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:NORTH HILLS SURGERY CENTER, LLC
Other - Org Name:NORTH HILLS SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:ASHBY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:479-713-6110
Mailing Address - Street 1:3271 N WIMBERLY DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-4033
Mailing Address - Country:US
Mailing Address - Phone:479-713-6100
Mailing Address - Fax:479-713-6146
Practice Address - Street 1:3271 N WIMBERLY DR
Practice Address - Street 2:SUITE 1
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4033
Practice Address - Country:US
Practice Address - Phone:479-713-6100
Practice Address - Fax:479-713-6146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR3637261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR11041Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID NUMB