WOODBRIDGE CENTER LLC NPI 1508978990

NPI Information

NPI: 1508978990
Provider Name: WOODBRIDGE CENTER LLC

Doing Business As: ENDOSCOPY AND SURGERY CENTER AT WOODBRIDGE HILLS

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

Specialization: Ambulatory Surgical

Address:
7901 ANGLING RD
PORTAGE, MI
ZIP 49024
Phone: (269) 324-8406
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WOODBRIDGE CENTER LLC is an ambulatory surgical clinic center in Portage, MI. WOODBRIDGE CENTER LLC NPI is 1508978990. The provider is registered as an organization entity type.
The provider Is Doing Business As Endoscopy And Surgery Center At Woodbridge Hills.

The provider's business location address is:

7901 ANGLING RD
PORTAGE, MI
ZIP 49024-714
Phone: (269) 324-8406

The provider's authorized official is Brij Dewan .
The authorized official title is President and has the following contact phone number (269) 385-9900.

The CLIA number assigned to this NPI record is 23D1046581 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 1/18/2012.

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	261QE0800X	Clinic/Center	Endoscopy			No
2	261QA1903X	Clinic/Center	Ambulatory Surgical	396814	MICHIGAN	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	0P24200	MEDICARE ID-TYPE UNSPECIFIED

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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