MEDICARE: RESEARCH SURGICAL CENTER, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1053651851
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESEARCH SURGICAL CENTER, LLC

Provider Business Mailing Address
First Line	:	2446 RESEARCH PKWY
Second Line	:	SUITE 100
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-1087
Country	:	US
Telephone Number	:	719-623-1050
Fax Number	:	205-824-6250

Provider Business Practice Location Address
First Line	:	1 CHASE CORPORATE DR
Second Line	:	SUITE 200
City	:	HOOVER
State	:	AL
Zip	:	35244-1026
Country	:	US
Telephone Number	:	205-824-6250
Fax Number	:	205-824-6251

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	MR. LARRY D TAYLOR
Credential	:
Telephone Number	:	205-824-6250

Provider Enumeration Date	:	02/15/2013
Last Update Date	:	02/15/2013

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