Physicians Surgery Center At Good Samaritan, Llc

NPI 1285980151 - Clinic/Center - 261QA1903X

NPI Details
NPI 1285980151
Enumeration Date 07/30/2012
Last Updated 06/27/2013
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name KATHERINE L. KATHERINE
Position MEDICARE AUTHORIZED OFFICIAL
Phone (618) 899-5703
Fax (618) 899-5704
Practice Location
2 GOOD SAMARITAN WAY
STE 200
MOUNT VERNON IL, 62864-2476, US
Phone (618) 899-5703
Fax (618) 899-5704
Business Location
2 GOOD SAMARITAN WAY
STE 200
MOUNT VERNON IL, 62864-2476, US
Phone (618) 899-5703
Fax (618) 899-5704
Toxanomy
Taxonomy Code 261QA1903X
License State Illinois
License Number 7003172
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According to our database, Physicians Surgery Center At Good Samaritan, Llc NPI is 1285980151, taxonomy code is 261QA1903X and license number is 7003172, license state is located at Illinois. Physicians Surgery Center At Good Samaritan, Llc physically located at 2 Good Samaritan Way, Mount Vernon IL, 62864-2476. NPI Number 1033115704 has the healthcare provider type.

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1285980151 NPI number is provided on an as is basis without warranty of any kind. 1285980151 is maintained by the National Plan & Provider Enumeration System. The contents of Physicians Surgery Center At Good Samaritan, Llc are for informational purposes only.