Provider Demographics
NPI:1184756579
Name:SOUTH CENTRAL SURGICAL CENTER
Entity type:Organization
Organization Name:SOUTH CENTRAL SURGICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHONHOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-765-1502
Mailing Address - Street 1:85 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:WARE
Mailing Address - State:MA
Mailing Address - Zip Code:01082-1667
Mailing Address - Country:US
Mailing Address - Phone:508-765-1502
Mailing Address - Fax:
Practice Address - Street 1:85 SOUTH ST
Practice Address - Street 2:
Practice Address - City:WARE
Practice Address - State:MA
Practice Address - Zip Code:01082-1667
Practice Address - Country:US
Practice Address - Phone:508-765-1502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1700621OtherUNITED HEALTHCARE
MA50350OtherFALLON
MA9785655Medicaid
MAM17307OtherBLUE SHIELD
MA9785655Medicaid