Basic Information
Provider Information
NPI: 1760043426
EntityType: 2
ReplacementNPI:  
OrganizationName: RMC SURGERY CENTER LLC
LastName:  
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Mailing Information
Address1: 3660 ARLINGTON AVE
Address2:  
City: RIVERSIDE
State: CA
PostalCode: 925063912
CountryCode: US
TelephoneNumber: 9517825157
FaxNumber:  
Practice Location
Address1: 21634 RETREAT PKWY
Address2:  
City: CORONA
State: CA
PostalCode: 928836100
CountryCode: US
TelephoneNumber: 9516836370
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/24/2019
LastUpdateDate: 04/08/2022
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: ATWOOD
AuthorizedOfficialFirstName: MARY
AuthorizedOfficialMiddleName: D
AuthorizedOfficialTitleorPosition: DIRECTOR, BUSINESS OFFICE
AuthorizedOfficialTelephone: 9517825136
IsSoleProprietor:  
IsOrganizationSubpart: N
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NPICertificationDate: 04/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QA1903X  Y Ambulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical

No ID Information.


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