Organization Name: | ADVANCED SURGERY CENTER OF CENTRAL IOWA, LLC |
NPI Number: | 1174999700 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DOUGLAS R HOISINGTON (CHIEF EXECUTIVE OFFICER) |
Mailing Address: | 12129 University Ave Suite 1000 Clive |
State: | IA US |
Postal Code: | 503258287 |
Phone Number: | 5155371222 |
Fax Number: | 5152251673 |
NPI Enumeration Date: | 08/18/2015 |
NPI Last Update Date: | 08/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA1903X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Ambulatory Surgical |
Taxonomy Definition: |