O'FALLON SURGICAL CENTER LLC NPI 1770042111

NPI Information

O'FALLON SURGICAL CENTER, LLC is an ambulatory surgical clinic center in O Fallon, IL. O'FALLON SURGICAL CENTER, LLC NPI is 1770042111. The provider is registered as an organization entity type.
The provider Is Doing Business As Physicians Surgical Center.

The provider's business location address is:

741 INSIGHT AVE
O FALLON, IL
ZIP 62269-193
Phone: (618) 239-0678
Fax: (618) 235-0471

The provider's authorized official is Shakeel Ahmed .
The authorized official title is Owner and has the following contact phone number (618) 239-0678.

The CLIA number assigned to this NPI record is 14D2163529 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/15/2019 and was last updated on 7/12/2021.

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:

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