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GREAT LAKES SURGERY CENTER, LC

Ambulatory Surgical

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Contact Information

GREAT LAKES SURGERY CENTER, LC
116 E 11TH ST
SUITE 202
SPENCER, IA  51301-4364
 Phone: 712-262-7350
 Fax: 712-262-7351
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Ambulatory Surgical

 261QA1903X 49 Ambulatory Surgical Center
Indicates primary specialty

NPI Profile & details for GREAT LAKES SURGERY CENTER, LC

NPI Number 1588726996
LBN Legal business name GREAT LAKES SURGERY CENTER, LC
Authorized official JOHN SYNHORST - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 12/14/2006
Last updated 03/23/2010 - About 16 years ago
Identifiers
IA Medicaid 0610345
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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