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SOUTHWEST SURGICAL PARTNERS LLC NPI 1336128479


NPI Information

NPI: 1336128479
Provider Name: SOUTHWEST SURGICAL PARTNERS LLC

Doing Business As: BEAVERCREEK SURGERY CENTER

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

Specialization: Ambulatory Surgical

Address:
3559 KEMP RD
SUITE 120
BEAVERCREEK, OH
ZIP 45431
Phone: (937) 458-4100
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SOUTHWEST SURGICAL PARTNERS LLC is an ambulatory surgical clinic center in Beavercreek, OH. SOUTHWEST SURGICAL PARTNERS LLC NPI is 1336128479. The provider is registered as an organization entity type.
The provider Is Doing Business As Beavercreek Surgery Center.

The provider's business location address is:

3559 KEMP RD
SUITE 120
BEAVERCREEK, OH
ZIP 45431-533
Phone: (937) 458-4100
Fax: (937) 458-4119

The provider's authorized official is Larry Gault .
The authorized official title is Administrator and has the following contact phone number (937) 458-4201.

The enumeration date for this NPI number is 1/16/2006 and was last updated on 8/22/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QA1903XClinic/CenterAmbulatory Surgical0558ASOHIOYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12139948MEDICAIDOHIO

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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