Provider Demographics
NPI:1770537698
Name:PHYSICIANS SURGERY CENTER OF FLORENCE LLC
Entity type:Organization
Organization Name:PHYSICIANS SURGERY CENTER OF FLORENCE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:HURLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-473-7000
Mailing Address - Street 1:PO BOX 849814
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284
Mailing Address - Country:US
Mailing Address - Phone:843-664-3300
Mailing Address - Fax:843-664-3723
Practice Address - Street 1:1580 FREEDOM BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-6074
Practice Address - Country:US
Practice Address - Phone:843-664-3300
Practice Address - Fax:843-664-3723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCASF-088261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCASC057Medicaid