SWEETWATER SURGERY CENTER LLC NPI 1336144617

NPI Information

NPI: 1336144617
Provider Name: SWEETWATER SURGERY CENTER LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 53D1001331

Address:
2761 COMMERCIAL WAY
ROCK SPRINGS, WY
ZIP 82901
Phone: (307) 382-6873
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SWEETWATER SURGERY CENTER LLC is an ambulatory surgical clinic center in Rock Springs, WY. SWEETWATER SURGERY CENTER LLC NPI is 1336144617. The provider is registered as an organization entity type.

The provider's business location address is:

2761 COMMERCIAL WAY
ROCK SPRINGS, WY
ZIP 82901-753
Phone: (307) 382-6873
Fax: (307) 382-6869

The provider's authorized official is Peter Jensen .
The authorized official title is Medical Director and has the following contact phone number (307) 382-6873.

The CLIA number assigned to this NPI record is 53D1001331 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/14/2005 and was last updated on 11/2/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	05-124	WYOMING	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	W9025	MEDICARE PIN	WYOMING

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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