Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Ambulatory Surgical |
261QA1903X | 49 | Ambulatory Surgical Center |
| NPI # | 1881238632 |
| LBN Legal business name | UNITED MEDICAL PARK ASC LLC |
| Authorized official | LEE ANNE BLACKWELL - (AUTHORIZED OFFICIAL) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 11/05/2019 |
| Last updated | 11/05/2019 - About 7 years ago |
| Identifiers | n/a |
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UNITED MEDICAL PARK ASC LLC
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