Basic Information
| Provider Information | |||||||||
| NPI: | 1508986621 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ASHLAND SURGERY CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 658 N MAIN STREET | ||||||||
| Address2: | |||||||||
| City: | ASHLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 975201710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5414825518 | ||||||||
| FaxNumber: | 5414823719 | ||||||||
| Practice Location | |||||||||
| Address1: | 658 N MAIN STREET | ||||||||
| Address2: | |||||||||
| City: | ASHLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 975201710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5414825518 | ||||||||
| FaxNumber: | 5414823719 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2007 | ||||||||
| LastUpdateDate: | 04/25/2008 | ||||||||
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| AuthorizedOfficialLastName: | SMALLEY | ||||||||
| AuthorizedOfficialFirstName: | TORI | ||||||||
| AuthorizedOfficialMiddleName: | I | ||||||||
| AuthorizedOfficialTitleorPosition: | BILLING ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 5414825518 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | 071556 | OR | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.