Healthcare Provider Details

I. General information

NPI: 1386624815
Provider Name (Legal Business Name): QUALITY SURGICENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2745 LINCOLNWAY
CLINTON IA
52732-7201
US

IV. Provider business mailing address

PO BOX 106
CAMANCHE IA
52730-0106
US

V. Phone/Fax

Practice location:
  • Phone: 563-242-3208
  • Fax: 563-242-4051
Mailing address:
  • Phone: 563-242-3208
  • Fax: 563-242-4051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. AHMED ELAHMADY
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 563-242-3208