Eastland Medical Plaza Surgicenter, Llc in Bloomington - Ambulatory Surgical
Eastland Medical Plaza Surgicenter, Llc - NPI 1699751289
Eastland Medical Plaza Surgicenter, Llc is a Ambulatory Surgical in Bloomington, Illinois. Eastland Medical Plaza Surgicenter, Llc practices all healthcare services and medical treatments related to Ambulatory Surgical. The NPI Number for Eastland Medical Plaza Surgicenter, Llc is 1699751289. The last update date is 2010-01-06.
Eastland Medical Plaza Surgicenter, Llc's current location address is 1505 Eastland Dr, Bloomington, Illinois. You can contact this provider via phone number 3096631997 and fax number 3096629527. The mailing address for Eastland Medical Plaza Surgicenter, Llc is 1505 Eastland Dr, Bloomington, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Eastland Medical Plaza Surgicenter, Llc |
|---|---|
| Address | 1505 Eastland Dr, Bloomington, Illinois |
| Phone Number | 3096631997 |
| Fax Number | 3096629527 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | BUSINESS O |
|---|---|
| Authorized Official Name | Frye Ann Jackie |
| Telephone Number | 3096631997 |
NPI Number Detail
| NPI Number | 1699751289 |
|---|---|
| Provider Enumeration Date | 2005-12-16 |
| Last Updated Date | 2010-01-06 |
Provider Mailing Address Detail
| Address | 1505 Eastland Dr |
|---|---|
| City | Bloomington |
| State | Illinois (IL) |
| Post Code | 617013534 |
| Phone Number | 3096631997 |
| Fax Number | 3096629527 |
Provider's Primary Taxonomy Detail
| Speciality | Ambulatory Surgical |
|---|---|
| Taxonomy | 261Qa1903X |
| Licence No | 7002413 |
|
Definition: Provides outpatient surgical services not requiring hospitalization. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 7002413 | IL | STATE LICENSE |
Post Comment/ Review Below
What is the unique provider identifier assigned to Eastland Medical Plaza Surgicenter, Llc?
The Eastland Medical Plaza Surgicenter, Llc has been issued the NPI (National Provider Identifier) 1699751289 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you share the physical location details of Eastland Medical Plaza Surgicenter, Llc?
The Eastland Medical Plaza Surgicenter, Llc is situated at 1505 Eastland Dr, in the city of Bloomington, state of IL, with the zip code 617013534.
What is the area of specialization for Eastland Medical Plaza Surgicenter, Llc, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Eastland Medical Plaza Surgicenter, Llc is Ambulatory Surgical, and the corresponding taxonomy code that categorizes this area of expertise is 261Qa1903X.
On what date did the Centers for Medicare & Medicaid Services issue the 1699751289 to Eastland Medical Plaza Surgicenter, Llc?
The Eastland Medical Plaza Surgicenter, Llc received its 1699751289 assignment from the Centers for Medicare & Medicaid Services on 2005-12-16.
When was the information related to Eastland Medical Plaza Surgicenter, Llc most recently updated or refreshed?
The details pertaining to the Eastland Medical Plaza Surgicenter, Llc, including its address, specialty, and other relevant information, were last updated or refreshed on 2010-01-06.
NPI Number: 1336142389
Address: Po Box 2004, East Syracuse, NY