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NPI Code Detail

MEDICARE: LAKE CUMBERLAND SURGERY CENTER LP

MEDICARE: LAKE CUMBERLAND SURGERY CENTER LP
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
1261QA1903XAmbulatory Surgical Clinic/Center300141KY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00000869OTHERKYRAILROAD MEDICARE ASC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000000288161OTHERKYBCBS

General Provider Information

NPI Number : 1720143779
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAKE CUMBERLAND SURGERY CENTER LP
Provider Business Mailing Address
First Line : 330 SEVEN SPRINGS WAY
Second Line :
City : BRENTWOOD
State : TN
Zip : 37027-5098
Country : US
Telephone Number : 615-920-7000
Fax Number : 615-920-8913
Provider Business Practice Location Address
First Line : 301 LANGDON ST
Second Line :
City : SOMERSET
State : KY
Zip : 42503-2750
Country : US
Telephone Number : 606-678-9688
Fax Number : 606-679-7479
Authorized Official
Title or Position : SECRETARY
Name : CHARLOTTE LAWRENCE
Credential :
Telephone Number : 615-920-7000
Provider Enumeration Date : 12/27/2006
Last Update Date : 05/27/2026

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Directions to “LAKE CUMBERLAND SURGERY CENTER LP ” Practice Location

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