WEST LAKES SURGERY CENTER LLC; NPI #1104933696

Contact Information

WEST LAKES SURGERY CENTER LLC

12499 UNIVERSITY AVE
SUITE 100
CLIVE, IA 50325-8281

Phone: 515-974-5050
Fax:
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 WEST LAKES SURGERY CENTER LLC

NPI # 1104933696

LBN Legal business name WEST LAKES SURGERY CENTER LLC

Authorized official TERI FORMANEK - (PRESIDENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 08/23/2006

Last updated 06/04/2020 - About 6 years ago

Identifiers

	License #	NA
IA	Medicaid	0610352
IA	Other	F252394	CARPENTERS DISTRICT COUN
IA	Other	F252394	CIGNA
IA	Other	61026	FEDERAL EMPLOYEES HEALTH
IA	Other	F252394	MIDLANDS AETNA
IA	Other	61026	WELLMARK BCBS
IA	Other	61026	WELLMARK HEALTH PLANS IA

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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WEST LAKES SURGERY CENTER LLC

Contact Information

Specialty

Ambulatory Surgical

NPI Profile & details for WEST LAKES SURGERY CENTER LLC

Reviews for WEST LAKES SURGERY CENTER LLC