Provider Demographics
NPI:1932770823
Name:EARLY BIRD SURGICAL LLC
Entity Type:Organization
Organization Name:EARLY BIRD SURGICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WRENSFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:340-777-8918
Mailing Address - Street 1:4002 RAPHUNE HILL RD STE 4
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802-2903
Mailing Address - Country:US
Mailing Address - Phone:340-777-8918
Mailing Address - Fax:
Practice Address - Street 1:4002 RAPHUNE HILL RD STE 4
Practice Address - Street 2:
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-2903
Practice Address - Country:US
Practice Address - Phone:340-777-8918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-02
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty