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Ambulatory Surgery Center Of Centralia, Llc
Clinic/Center in Centralia, Illinois
NPI 1265495824

Ambulatory Surgery Center Of Centralia, Llc is a Clinic/Center based in Centralia, IL. Ambulatory Surgery Center Of Centralia, Llc practices in Centralia, IL. The NPI Number for Ambulatory Surgery Center Of Centralia, Llc is 1265495824 and holds a License No. 036065384 (Illinois).

The current practice location address for Ambulatory Surgery Center Of Centralia, Llc is 1045 Martin Luther King Dr, Centralia, IL and can be reached out via phone at 618-532-3110 and via fax at 618-532-3110.

Location: 1045 Martin Luther King Dr, Centralia, IL, 62801-3001
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1265495824
Provider Name
Ambulatory Surgery Center Of Centralia, Llc
Credential
Provider Entity Type
Organization
Address
1045 Martin Luther King Dr, Centralia, IL, 62801-3001
Phone Number
618-532-3110
Fax Number
618-532-3110
Provider Enumeration Date
04/06/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
06130323 01 BLUE CROSS BLUE SHIELD
036065384 05 IL
CH8278 01 RR MEDICARE
institution
Provider Business Practice Location Address Details
Address
1045 Martin Luther King Dr
City
Centralia
State
Illinois
Zip
62801-3001
Phone Number
618-532-3110
Fax Number
618-532-3110
person
Provider Business Mailing Address Details
Address
1045 Martin Luther King Dr
City
Centralia
State
Illinois
Zip
62801-3001
Phone Number
618-532-3110
Fax Number
618-532-3110
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
036065384 (Illinois)
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
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