MEDICARE: ENDOSCOPY CENTER OF DAYTON LTD

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	1151AS	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114926714
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENDOSCOPY CENTER OF DAYTON LTD

Provider Business Mailing Address
First Line	:	4200 INDIAN RIPPLE RD
Second Line	:
City	:	BEAVERCREEK
State	:	OH
Zip	:	45440-3248
Country	:	US
Telephone Number	:	937-320-5050
Fax Number	:	937-320-5060

Provider Business Practice Location Address
First Line	:	4200 INDIAN RIPPLE RD
Second Line	:
City	:	BEAVERCREEK
State	:	OH
Zip	:	45440-3248
Country	:	US
Telephone Number	:	937-320-5050
Fax Number	:	937-320-5060

Authorized Official
Title or Position	:	OFFICER/AUTHORIZED OFFICIAL
Name	:	LAURA MEEKER
Credential	:
Telephone Number	:	937-320-5050

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	09/30/2025

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Directions to “ENDOSCOPY CENTER OF DAYTON LTD ” Practice Location

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