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PREMIUM SURGERY CENTER LLC

Surgery Yellow Pages

Elyria, Ohio

Provider NPI: 1588633184

Organization Information:
Organization Name:  PREMIUM SURGERY CENTER LLC


Practice Location:
5319 HOAG DR  ELYRIA, OH 44035 US
Tel: 440-930-6042  Fax: --

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


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y261QA1903XAmbulatory Health Care Facilities
Clinic/Center
Ambulatory Surgical
OH0572AS

Other Provider Identifiers:

IssuerNumberStateType
BLUE CROSS BLUE SHIELD00000033876701
2213107OH05
RR MEDICAREP0012422901
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin



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