Provider Demographics
NPI:1982147070
Name:NORTHWEST TN SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:NORTHWEST TN SURGERY CENTER, LLC
Other - Org Name:UNION CITY SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:CALFEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:731-885-6300
Mailing Address - Street 1:1722 E REELFOOT AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:UNION CITY
Mailing Address - State:TN
Mailing Address - Zip Code:38261-6050
Mailing Address - Country:US
Mailing Address - Phone:731-885-6300
Mailing Address - Fax:615-620-9301
Practice Address - Street 1:1722 E REELFOOT AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:UNION CITY
Practice Address - State:TN
Practice Address - Zip Code:38261-6050
Practice Address - Country:US
Practice Address - Phone:731-885-6300
Practice Address - Fax:615-620-9301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-22
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical