Healthcare Provider Details

I. General information

NPI: 1881456606
Provider Name (Legal Business Name): AMES SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2024
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 BAILEY AVE
AMES IA
50010-9667
US

IV. Provider business mailing address

2120 BAILEY AVE
AMES IA
50010-9667
US

V. Phone/Fax

Practice location:
  • Phone: 586-864-6006
  • Fax:
Mailing address:
  • Phone: 515-956-7980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: GARRETT KORRECT
Title or Position: BOARD MEMBER
Credential:
Phone: 515-239-4400