GREAT LAKES SURGERY CENTER LLC NPI 1003273129

NPI Information

NPI: 1003273129
Provider Name: GREAT LAKES SURGERY CENTER LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 23D1090689

Address:
2848 NILES RD
SUITE B
SAINT JOSEPH, MI
ZIP 49085
Phone: (269) 428-3304
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GREAT LAKES SURGERY CENTER LLC is an ambulatory surgical clinic center in Saint Joseph, MI. GREAT LAKES SURGERY CENTER LLC NPI is 1003273129. The provider is registered as an organization entity type.

The provider's business location address is:

2848 NILES RD
SUITE B
SAINT JOSEPH, MI
ZIP 49085-352
Phone: (269) 428-3304

The provider's authorized official is David N. Brown .
The authorized official title is Manager Member and has the following contact phone number (269) 428-3300.

The CLIA number assigned to this NPI record is 23D1090689 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/20/2016 and was last updated on 11/12/2021.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QS0132X	Clinic/Center	Ophthalmologic Surgery			No
2	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: 5/5/2024

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