Provider Demographics
NPI:1942367636
Name:CENTER FOR ORTHOPAEDIC SURGERY, LLC
Entity Type:Organization
Organization Name:CENTER FOR ORTHOPAEDIC SURGERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:F
Authorized Official - Last Name:ELKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-329-7402
Mailing Address - Street 1:118 PROFESSIONAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-1178
Mailing Address - Country:US
Mailing Address - Phone:803-329-3134
Mailing Address - Fax:
Practice Address - Street 1:134 PROFESSIONAL PARK DR
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1178
Practice Address - Country:US
Practice Address - Phone:803-329-7402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical