1730140237 NPI number — LINDEN OAKS SURGERY CENTER INC

Table of content: (NPI 1730140237)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730140237 NPI number — LINDEN OAKS SURGERY CENTER INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LINDEN OAKS SURGERY CENTER INC
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:
1730140237
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 HAGEN DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCHESTER
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14625
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-267-8200
Provider Business Mailing Address Fax Number:
585-267-8256

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 HAGEN DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-267-8200
Provider Business Practice Location Address Fax Number:
585-267-8256
Provider Enumeration Date:
04/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DOYLE
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
J
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
585-267-8250

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  2701232R , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: FA0727 . This is a "PREFERRED ONE" identifier . This identifiers is of the category "OTHER".
  • Identifier: P0140059LH . This is a "CHILD HEALTH PLUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: P0140059LH . This is a "MONROE PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: P0140059LH . This is a "EXCELLUS HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: P0140059LH . This is a "BLUE POINT" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00060627 . This is a "MEDICARE RAILROAD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7632063 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7632063 . This is a "AETNA EL PASO" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: P0140059LH . This is a "BCBS ROCHESTER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7632063 . This is a "AETNA EPO US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: BA0101 . This is a "UPSTATE MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: P0140059LH . This is a "FAMILY HEALTH PLUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01980574 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: P0140059LH . This is a "BLUE CHOICE" identifier . This identifiers is of the category "OTHER".




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