1184784209 NPI number — AMERICAN SURGICAL CENTERS II, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184784209 NPI number — AMERICAN SURGICAL CENTERS II, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMERICAN SURGICAL CENTERS II, 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:
AMERICAN SURGICAL CENTERS
Provider Other Organization Name Type Code:
3
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:
1184784209
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/16/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7091 ORCHARD LAKE RD STE 230
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST BLOOMFIELD
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48322-3651
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-312-9886
Provider Business Mailing Address Fax Number:
248-538-7298

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7091 ORCHARD LAKE RD.
Provider Second Line Business Practice Location Address:
SUITE #230
Provider Business Practice Location Address City Name:
WEST BLOOMFIELD
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48322-3651
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-538-7095
Provider Business Practice Location Address Fax Number:
248-538-7298
Provider Enumeration Date:
12/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TRUJILLO
Authorized Official First Name:
BILJANA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT AND CEO
Authorized Official Telephone Number:
248-538-7095

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  636831 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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