| Organization Name: | WARTBURG SURGERY CENTER LLC |
| NPI Number: | 1104055425 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID HOLST (PRESIDENT) |
| Mailing Address: | 1236 Knoxville Hwy Wartburg |
| State: | TN US |
| Postal Code: | 378874200 |
| Phone Number: | 4233465566 |
| Fax Number: | |
| NPI Enumeration Date: | 07/08/2009 |
| NPI Last Update Date: | 06/22/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 0000000133 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |