Healthcare Provider Details

I. General information

NPI: 1356348148
Provider Name (Legal Business Name): FARMINGTON SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CIRCLE DR SUITE 200
FARMINGTON CT
06032-1970
US

IV. Provider business mailing address

1 CIRCLE DR SUITE 200
FARMINGTON CT
06032-1970
US

V. Phone/Fax

Practice location:
  • Phone: 860-679-6000
  • Fax: 860-679-6060
Mailing address:
  • Phone: 860-679-6000
  • Fax: 860-679-6060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number0288
License Number StateCT

VIII. Authorized Official

Name: MRS. PAMELA LYNN MARSHALKOWSKI
Title or Position: ADMINISTRATOR/DIRECTOR OF NURSING
Credential: RN, BSN
Phone: 860-679-6001