Provider Demographics
NPI:1720081870
Name:ORTHOPAEDIC AMBULATORY SURGICAL INTERVENTION SERVICES, LLC
Entity Type:Organization
Organization Name:ORTHOPAEDIC AMBULATORY SURGICAL INTERVENTION SERVICES, LLC
Other - Org Name:OASIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-498-9898
Mailing Address - Street 1:7000 WHIPPLE AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-7134
Mailing Address - Country:US
Mailing Address - Phone:330-498-9898
Mailing Address - Fax:342-236-0853
Practice Address - Street 1:7000 WHIPPLE AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-7134
Practice Address - Country:US
Practice Address - Phone:330-498-9898
Practice Address - Fax:234-236-0853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH261QA1903X261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2167435Medicaid
OH3611221Medicare ID - Type UnspecifiedPROVIDER ID