Provider Demographics
NPI:1922274802
Name:NORTH RIVER SURGICAL CENTER PHYSICIANS
Entity Type:Organization
Organization Name:NORTH RIVER SURGICAL CENTER PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-750-0022
Mailing Address - Street 1:301 RICE MINE RD NE
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-2403
Mailing Address - Country:US
Mailing Address - Phone:205-750-0022
Mailing Address - Fax:
Practice Address - Street 1:301 RICE MINE RD NE
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-2403
Practice Address - Country:US
Practice Address - Phone:205-750-0022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH RIVER SURGICAL CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000075628Medicare PIN