Provider Demographics
NPI:1770935777
Name:COLUMBUS SURGERY CENTER LLC
Entity type:Organization
Organization Name:COLUMBUS SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJMONY
Authorized Official - Middle Name:S
Authorized Official - Last Name:PANNU
Authorized Official - Suffix:
Authorized Official - Credentials:MD, RPVI, FSVM
Authorized Official - Phone:507-269-2446
Mailing Address - Street 1:895 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-3345
Mailing Address - Country:US
Mailing Address - Phone:614-917-0696
Mailing Address - Fax:
Practice Address - Street 1:895 S STATE ST
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-3345
Practice Address - Country:US
Practice Address - Phone:614-917-0696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-01
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
APPLIED FOR261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical