Provider Demographics
NPI:1255578936
Name:WEST CENTRAL SURGICAL CENTER, LLC
Entity type:Organization
Organization Name:WEST CENTRAL SURGICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:G
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:419-843-1370
Mailing Address - Street 1:7055 W CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617-1114
Mailing Address - Country:US
Mailing Address - Phone:419-843-1370
Mailing Address - Fax:419-843-1362
Practice Address - Street 1:7055 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-1114
Practice Address - Country:US
Practice Address - Phone:419-843-1370
Practice Address - Fax:419-843-1362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-16
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNA03633367500000X
OHNA01265367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2957939Medicaid
OH755839Medicaid
OH755884Medicaid
OH2210333Medicaid
OH000000684582OtherANTHEM-RICICA
OH0756338Medicaid
OH1780621680OtherHOHENBERGER NPI
OHH090512OtherMEDICARE PTAN FOURMAN
OH1346238169OtherANGELA BROWN NPI
OH1548209927OtherDAVIES NPI
OH1588685523OtherNPI-NEENAN
OH2134390Medicaid
OH8203196OtherCHRISTINE DAVIES, CRNA
OH000000685118OtherANTHEM-HEINEY
OH1245239110OtherNPI-BYERS
OH1265487730OtherNPI-HEINEY
OH2134514Medicaid
OH8241865OtherLINDA HOHENBERGER
OHHE8203877OtherMEDICARE PTAN
OH1790769099OtherNPI-RICICA
OH2957939Medicaid
OHH042050Medicare PIN
OH=========-01OtherBWC
OH000000685118OtherANTHEM-HEINEY
OH8241865OtherLINDA HOHENBERGER
OH2134514Medicaid
OH2134390Medicaid
OH8203871Medicare PIN