Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Ambulatory Surgical |
261QA1903X | 49 | Ambulatory Surgical Center |
| NPI # | 1912045154 |
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| LBN Legal business name | CROISAN RIDGE SURGERY CENTER, LLC | ||||
| Authorized official | CRAIG ANDERSON - (PRESIDENT) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 02/01/2007 | ||||
| Last updated | 10/26/2011 - About 15 years ago | ||||
| Identifiers |
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