National Provider Identifier Database

CENTER FOR SURGICAL SPECIALTIES LLC
Ambulatory Surgical


Contact Information

CENTER FOR SURGICAL SPECIALTIES, LLC
310 COLLOREDO BLVD
STE B
SHELBYVILLE, TN37160
Phone: 931-684-3504
Fax: 931-684-5122
Website:
Specialty Taxonomy Code
* Ambulatory Surgical 261QA1903X

* Indicates primary specialty

NPI Profile & details for CENTER FOR SURGICAL SPECIALTIES, LLC

NPI Number 1770524878
Legal business name
LBN
CENTER FOR SURGICAL SPECIALTIES, LLC
Authorized official DOMENIC CANONICO - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 06/09/2006
Last updated 08/20/2013 - About 13 years ago
Sole proprietor1 Not specified
Identifiers
  • TN License #: 0000000128
  • TN Medicaid: 3288771E3739743
  • TN Other: 4052519 BCBST

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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