Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Ambulatory Surgical |
261QA1903X | 49 | Ambulatory Surgical Center |
| NPI # | 1437623626 |
| LBN Legal business name | PRIME SURGICAL SUITES, LLC |
| Authorized official | KAREN SHADOWENS - (VP, CFO) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 01/22/2019 |
| Last updated | 11/08/2024 - More than a year ago |
| Identifiers | n/a |
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