PRINCE WILLIAM AMBULATORY SURGERY CENTER LLC NPI 1528077658

NPI Information

NPI: 1528077658
Provider Name: PRINCE WILLIAM AMBULATORY SURGERY CENTER, LLC

Other Name: PRINCE WILLIAM SURGERY CENTER

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

Specialization: Ambulatory Surgical

Address:
8644 SUDLEY RD
SUITE 201
MANASSAS, VA
ZIP 20110
Phone: (703) 369-8525
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PRINCE WILLIAM AMBULATORY SURGERY CENTER, LLC is an ambulatory surgical clinic center in Manassas, VA. PRINCE WILLIAM AMBULATORY SURGERY CENTER, LLC NPI is 1528077658. The provider is registered as an organization entity type.
The provider Other Name Is Prince William Surgery Center.

The provider's business location address is:

8644 SUDLEY RD
SUITE 201
MANASSAS, VA
ZIP 20110-417
Phone: (703) 369-8525
Fax: (571) 229-1533

The provider's authorized official is Kristen O'connor .
The authorized official title is Officer / Authorized Official and has the following contact phone number (615) 376-7315.

The enumeration date for this NPI number is 8/7/2006 and was last updated on 11/29/2021.

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	OH695	VIRGINIA	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	010274656	MEDICAID	VIRGINIA
2	2579620	OTHER		UHC
3	2142411	OTHER		MDIPA/OPTIMUM CHOICE
4	186080	OTHER		ANTHEM HEALTHKEEPERS
5	2142411	OTHER		MAMSI/UHC
6	9731258	OTHER		CIGNA
7	186080	OTHER	VIRGINIA	ANTHEM

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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