Organization Name:  MCALESTER AMBULATORY SURGERY CENTER, LLC


Practice Location:
4 E CLARK BASS BLVD  MCALESTER, OK 74501 US
Tel: 918-421-6700  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
Y	261QA1903X	Ambulatory Health Care Facilities Clinic/Center Ambulatory Surgical	OK	0068

Other Provider Identifiers:

Issuer	Number	State	Type
BLUE CROSS/BLUE SHIELD	000371048-001	OK	01
DEPARTMENT OF LABOR - WC	175753300	OK	01
	100748940A	OK	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin