Healthcare Provider Details
I. General information
NPI: 1558504050
Provider Name (Legal Business Name): WB SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/13/2009
Last Update Date: 11/27/2022
Certification Date: 11/27/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3704 LAPALCO BLVD
HARVEY LA
70058-2332
US
IV. Provider business mailing address
1A BURTON HILLS BLVD # L&C
NASHVILLE TN
37215-6187
US
V. Phone/Fax
- Phone: 985-234-9700
- Fax:
- Phone: 615-665-1283
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JEFFREY
E.
SNODGRASS
Title or Position: PRESIDENT
Credential:
Phone: 615-665-1283