1598211419 NPI number — ACCESS AMBULATORY SURGERY CENTER, LLC

Table of content: (NPI 1598211419)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598211419 NPI number — ACCESS AMBULATORY SURGERY CENTER, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACCESS AMBULATORY SURGERY CENTER, 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:
1598211419
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/31/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 HAMPTON RD
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
EXETER
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03833-4848
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-775-7575
Provider Business Mailing Address Fax Number:
603-778-9680

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
45 DARTMOUTH DRIVE
Provider Second Line Business Practice Location Address:
LOT 4
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03032
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-775-7575
Provider Business Practice Location Address Fax Number:
603-778-9680
Provider Enumeration Date:
08/31/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SIEGEL
Authorized Official First Name:
JOSHUA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
603-775-7575

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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