1841759040 NPI number — BEAVER VALLEY AMBULATORY SURGERY CENTER, LLC

Table of content: JAMESHA LASHAY MASON WILLIAMS (NPI 1558124545)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841759040 NPI number — BEAVER VALLEY AMBULATORY SURGERY CENTER, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEAVER VALLEY 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:
1841759040
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/15/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
766 E PITTSBURGH ST STE 103
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15601-2678
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-346-2400
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
79 WAGNER ROAD
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
MONACA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15061-2489
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-624-9901
Provider Business Practice Location Address Fax Number:
724-624-9910
Provider Enumeration Date:
03/18/2019

Additional Information

Authorized Official

Authorized Official Last Name:
SUDAR
Authorized Official First Name:
CHERYL
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
724-694-9901

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)





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