Healthcare Provider Details

I. General information

NPI: 1003581794
Provider Name (Legal Business Name): LENOX SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2021
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36555 26 MILE ROAD STE 1900
LENOX MI
48048
US

IV. Provider business mailing address

26901 BEAUMONT BLVD BLDG D-6
SOUTHFIELD MI
48033-3849
US

V. Phone/Fax

Practice location:
  • Phone: 586-786-8050
  • Fax:
Mailing address:
  • Phone: 947-522-1963
  • 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: MATTHEW E COX
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 947-522-3333