Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Endoscopy |
261QE0800X | |||
Ambulatory Surgical |
261QA1903X | 49 | Ambulatory Surgical Center |
| NPI # | 1144297003 |
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| LBN Legal business name | TACOMA ENDOSCOPY CENTER | ||||||||||||||||||||
| Authorized official | JOHN CARROUGHER - (MEDICAL DIRECTOR) | ||||||||||||||||||||
| Entity | Organization | ||||||||||||||||||||
| Organization subpart 1 | No | ||||||||||||||||||||
| Enumeration date | 02/28/2006 | ||||||||||||||||||||
| Last updated | 01/14/2011 - About 15 years ago | ||||||||||||||||||||
| Identifiers |
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TACOMA ENDOSCOPY CENTER
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