| Organization Name: | SIDNEY ASC LLC |
| NPI Number: | 1063492437 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PHILLIP A. CLENDENIN (PRESIDENT) |
| Mailing Address: | 283 Looney Rd Piqua |
| State: | OH US |
| Postal Code: | 453564147 |
| Phone Number: | 9377783848 |
| Fax Number: | 9377783853 |
| NPI Enumeration Date: | 01/20/2006 |
| NPI Last Update Date: | 03/15/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 0321AS |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |