Basic Information
Provider Information
NPI: 1912933680
EntityType: 2
ReplacementNPI:  
OrganizationName: SOUTHWESTERN AMBULATORY SURGERY CENTER, LLC
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Mailing Information
Address1: 14201 DALLAS PKWY
Address2:  
City: DALLAS
State: TX
PostalCode: 752542916
CountryCode: US
TelephoneNumber: 9727633859
FaxNumber: 9729203445
Practice Location
Address1: 500 LEWIS RUN RD
Address2: SUITE 202
City: PITTSBURGH
State: PA
PostalCode: 151223048
CountryCode: US
TelephoneNumber: 4124696964
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/24/2006
LastUpdateDate: 08/05/2020
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: HARTSHORN
AuthorizedOfficialFirstName: CHRISTOPHER
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AuthorizedOfficialTitleorPosition: OFFICER / AUTHORIZED OFFICIAL
AuthorizedOfficialTelephone: 3148002017
IsSoleProprietor:  
IsOrganizationSubpart: N
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NPICertificationDate: 08/05/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QA1903X45231500PAY Ambulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical

No ID Information.


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