Organization Name: | SURGICAL SERVICES P.C. |
NPI Number: | 1154433886 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RAY VILLANUEVA (PRESIDENT) |
Mailing Address: | 604 S Main St Sweetwater |
State: | TN US |
Postal Code: | 378742708 |
Phone Number: | 4233374508 |
Fax Number: | 4233374588 |
NPI Enumeration Date: | 08/31/2006 |
NPI Last Update Date: | 06/24/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA1903X |
License Number: | 0000000035 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Ambulatory Surgical |
Taxonomy Definition: |