Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Ambulatory Surgical |
261QA1903X | 49 | Ambulatory Surgical Center |
| NPI Number | 1417287137 |
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| LBN Legal business name | EAST PORTLAND SURGERY CENTER LLC | ||||||||||||
| Authorized official | ERIC BOON - (MARKET PRESIDENT) | ||||||||||||
| Entity | Organization | ||||||||||||
| Organization subpart 1 | No | ||||||||||||
| Enumeration date | 12/31/2009 | ||||||||||||
| Last updated | 09/19/2024 - More than a year ago | ||||||||||||
| Identifiers |
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EAST PORTLAND SURGERY CENTER LLC
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