Provider Demographics
NPI:1972549491
Name:UNION CITY ASC LLC
Entity Type:Organization
Organization Name:UNION CITY ASC LLC
Other - Org Name:SUMMIT ENDOSCOPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HAYLEY
Authorized Official - Middle Name:MAREE
Authorized Official - Last Name:SUMMERS
Authorized Official - Suffix:
Authorized Official - Credentials:CPPM
Authorized Official - Phone:731-884-0600
Mailing Address - Street 1:1109 REELFOOT AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:UNION CITY
Mailing Address - State:TN
Mailing Address - Zip Code:38261-5856
Mailing Address - Country:US
Mailing Address - Phone:731-884-0600
Mailing Address - Fax:731-885-6171
Practice Address - Street 1:1109 REELFOOT AVE
Practice Address - Street 2:SUITE C
Practice Address - City:UNION CITY
Practice Address - State:TN
Practice Address - Zip Code:38261-5856
Practice Address - Country:US
Practice Address - Phone:731-884-0600
Practice Address - Fax:731-885-6171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000102261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP00211352OtherRAILROAD MEDICARE
TN3288928Medicare PIN