1023123296 NPI number — ASSOCIATES SURGERY CENTERS, LLC

Table of content: (NPI 1023123296)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023123296 NPI number — ASSOCIATES SURGERY CENTERS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASSOCIATES SURGERY CENTERS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023123296
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/17/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 644220
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15264-4220
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-653-3080
Provider Business Mailing Address Fax Number:
412-650-8860

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9970 MOUNTAIN VIEW DR
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
WEST MIFFLIN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15122-2474
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-655-3046
Provider Business Practice Location Address Fax Number:
412-650-8405
Provider Enumeration Date:
08/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CIBIK
Authorized Official First Name:
LISA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
MD/MEDICAL DIRECTOR
Authorized Official Telephone Number:
412-653-3080

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  50361501 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 17670 . This is a "ELDER HEALTH BRAVO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 623740 . This is a "ADVANTRA/ HEALTH AMERICA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: P00404252 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1019337320001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 411715 . This is a "UPMC HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 000000212316 . This is a "UNISON HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 3834221 . This is a "CIGNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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