Provider Demographics
NPI:1336364231
Name:SURGERY CENTER AT LIBERTY HOSPITAL, L.L.C.
Entity Type:Organization
Organization Name:SURGERY CENTER AT LIBERTY HOSPITAL, L.L.C.
Other - Org Name:SURGERY CENTER AT LIBERTY HOSPITAL, L.L.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GOVERNING BODY PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SANTOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGE, MD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-883-2401
Mailing Address - Street 1:2529 GLENN HENDREN DR STE 100
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-9601
Mailing Address - Country:US
Mailing Address - Phone:816-883-2401
Mailing Address - Fax:816-883-2402
Practice Address - Street 1:2529 GLENN HENDREN DR STE 100
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-9601
Practice Address - Country:US
Practice Address - Phone:816-883-2401
Practice Address - Fax:816-883-2402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical