Healthcare Provider Details

I. General information

NPI: 1689251720
Provider Name (Legal Business Name): MASON CITY AMBULATORY SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

990 4TH ST SW
MASON CITY IA
50401-2861
US

IV. Provider business mailing address

990 4TH ST SW
MASON CITY IA
50401-2861
US

V. Phone/Fax

Practice location:
  • Phone: 641-494-2000
  • Fax: 641-494-2018
Mailing address:
  • Phone: 641-494-2000
  • Fax: 641-494-2018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: DR. KEVIN R RIER
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 641-494-2000