STARK AMBULATORY SURGERY CENTER, LLC; NPI #1740260926

Contact Information

STARK AMBULATORY SURGERY CENTER, LLC

4360 FULTON DR NW
SUITE C
CANTON, OH 44718-2878

Phone: 330-305-2020
Fax: 330-305-2020
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 STARK AMBULATORY SURGERY CENTER, LLC

NPI Number 1740260926

LBN Legal business name STARK AMBULATORY SURGERY CENTER, LLC

Authorized official CHRISTOPHER HARTSHORN - (OFFICER/AUTHORIZED OFFICIAL)

Entity Organization

Organization subpart ¹ No

Enumeration date 01/23/2006

Last updated 09/17/2024 - More than a year ago

Identifiers

OH	License #	0750AS
OH	Medicaid	2533299

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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