CRYSTAL CLINIC SURGERY CENTER, INC.; NPI #1104818038

Contact Information

CRYSTAL CLINIC SURGERY CENTER, INC.

3975 EMBASSY PKWY
SUITE 202
AKRON, OH 44333-8320

Phone: 330-668-4085
Fax: 330-668-2624
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Ambulatory Surgical	261QA1903X	49	Ambulatory Surgical Center

Indicates primary specialty

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NPI Profile & details for CRYSTAL CLINIC SURGERY CENTER, INC.

NPI Number 1104818038

LBN Legal business name CRYSTAL CLINIC SURGERY CENTER, INC.

Authorized official JOANNE STONE - (ADMINISTRATOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 08/17/2005

Last updated 04/20/2008 - About 18 years ago

Identifiers

OH	License #	0102AS-153
OH	Other	157362	ANTHEM PROVIDER NO.
OH	Other	100773	KAISER PROVIDER NO.
OH	Other	68-00067	UNITED HEALTHCARE PROV NO

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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