Provider Demographics
NPI:1205421542
Name:TROY SC CENTER LLC
Entity type:Organization
Organization Name:TROY SC CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DUFFY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-656-0917
Mailing Address - Street 1:1560 E MAPLE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-1135
Mailing Address - Country:US
Mailing Address - Phone:248-396-8109
Mailing Address - Fax:
Practice Address - Street 1:1560 E MAPLE RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-1135
Practice Address - Country:US
Practice Address - Phone:248-817-2348
Practice Address - Fax:248-688-9219
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TROY SC HOLDINGS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-09
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical