Provider Demographics
NPI:1356348148
Name:FARMINGTON SURGERY CENTER LLC
Entity type:Organization
Organization Name:FARMINGTON SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/DIRECTOR OF NURSING
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MARSHALKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:860-679-6001
Mailing Address - Street 1:1 CIRCLE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-1970
Mailing Address - Country:US
Mailing Address - Phone:860-679-6000
Mailing Address - Fax:860-679-6060
Practice Address - Street 1:1 CIRCLE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1970
Practice Address - Country:US
Practice Address - Phone:860-679-6000
Practice Address - Fax:860-679-6060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0288261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical