LOGAN SURGICAL SUITES LLC NPI 1104301613

NPI Information

NPI: 1104301613
Provider Name: LOGAN SURGICAL SUITES LLC

Doing Business As: ADVANCED SURGERY CENTER OF NORTHERN UTAH

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
55 EAST GOLF COURSE ROAD
LOGAN, UT
ZIP 84321
Phone: (435) 760-3734
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LOGAN SURGICAL SUITES LLC is an ambulatory surgical clinic center in Logan, UT. LOGAN SURGICAL SUITES LLC NPI is 1104301613. The provider is registered as an organization entity type.
The provider Is Doing Business As Advanced Surgery Center Of Northern Utah.

The provider's business location address is:

55 EAST GOLF COURSE ROAD
LOGAN, UT
ZIP 84321-001
Phone: (435) 760-3734

The provider's authorized official is Marielle Whitlock .
The authorized official title is Administrator and has the following contact phone number (435) 760-3734.

The CLIA number assigned to this NPI record is 46D2156197 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/1/2018 and was last updated on 9/23/2021.

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			Yes

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

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