Provider Demographics
NPI:1952912552
Name:SURGERY CENTER OF NORTH CENTRAL OHIO LLC
Entity Type:Organization
Organization Name:SURGERY CENTER OF NORTH CENTRAL OHIO LLC
Other - Org Name:THE SURGERY CENTER OF NORTH CENTRAL OHIO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GAVIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-397-9187
Mailing Address - Street 1:1 EMERALD PKWY
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:OH
Mailing Address - Zip Code:44857-2671
Mailing Address - Country:US
Mailing Address - Phone:419-577-0095
Mailing Address - Fax:419-577-8858
Practice Address - Street 1:1 EMERALD PKWY
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:OH
Practice Address - Zip Code:44857-2671
Practice Address - Country:US
Practice Address - Phone:419-577-0095
Practice Address - Fax:419-577-8858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-17
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical