Provider Demographics
NPI:1013665389
Name:APEX SURGICAL CENTER LLC
Entity Type:Organization
Organization Name:APEX SURGICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:RISE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-254-1500
Mailing Address - Street 1:1239 CORPORATE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:OCONOMOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:53066-4898
Mailing Address - Country:US
Mailing Address - Phone:262-254-1500
Mailing Address - Fax:
Practice Address - Street 1:1239 CORPORATE CENTER DR
Practice Address - Street 2:
Practice Address - City:OCONOMOWOC
Practice Address - State:WI
Practice Address - Zip Code:53066-4898
Practice Address - Country:US
Practice Address - Phone:262-254-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical