Provider Demographics
NPI:1922193515
Name:MAHONING VALLEY AMBULATORY SURGERY CENTER INC
Entity Type:Organization
Organization Name:MAHONING VALLEY AMBULATORY SURGERY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:EASTERDAY
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:570-386-5926
Mailing Address - Street 1:37 MEDICAL CROSSING RD
Mailing Address - Street 2:
Mailing Address - City:TAMAQUA
Mailing Address - State:PA
Mailing Address - Zip Code:18252-5565
Mailing Address - Country:US
Mailing Address - Phone:570-386-5926
Mailing Address - Fax:570-386-2959
Practice Address - Street 1:37 MEDICAL CROSSING RD
Practice Address - Street 2:
Practice Address - City:TAMAQUA
Practice Address - State:PA
Practice Address - Zip Code:18252-5565
Practice Address - Country:US
Practice Address - Phone:570-386-5926
Practice Address - Fax:570-386-2959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical