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Premium Surgery Center Llc
Ambulatory Surgical Clinic/Center in Elyria, Ohio
NPI 1588633184

Premium Surgery Center Llc is an Ambulatory Surgical Clinic/Center based in Elyria, OH and is specialized in Ambulatory Surgical. Premium Surgery Center Llc practices in Elyria, OH. The NPI Number for Premium Surgery Center Llc is 1588633184 and holds a License No. 0572AS (Ohio).

The current practice location address for Premium Surgery Center Llc is 5319 Hoag Dr, Elyria, OH and can be reached out via phone at 440-930-6042 and via fax at 440-930-6105.

Location: 5319 Hoag Dr, Elyria, OH, 44035
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1588633184
Provider Name
Premium Surgery Center Llc
Credential
Provider Entity Type
Organization
Address
5319 Hoag Dr, Elyria, OH, 44035
Phone Number
440-930-6042
Fax Number
440-930-6105
Provider Enumeration Date
03/16/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000000338767 01 BLUE CROSS BLUE SHIELD
2213107 05 OH
P00124229 01 RR MEDICARE
institution
Provider Business Practice Location Address Details
Address
5319 Hoag Dr
City
Elyria
State
Ohio
Zip
44035
Phone Number
440-930-6042
Fax Number
440-930-6105
person
Provider Business Mailing Address Details
Address
5319 Hoag Dr
City
Elyria
State
Ohio
Zip
44035
Phone Number
440-930-6042
Fax Number
440-930-6105
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Ambulatory Surgical
Taxonomy
261QA1903X
License No.
0572AS (Ohio)
Definition
Definition to come...
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