Healthcare Provider Details

I. General information

NPI: 1194239483
Provider Name (Legal Business Name): ATLANTIC COAST SURGICAL SUITES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2017
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325-2 LAFAYETTE RD
SEABROOK NH
03874-4539
US

IV. Provider business mailing address

325-2 LAFAYETTE RD
SEABROOK NH
03874-4539
US

V. Phone/Fax

Practice location:
  • Phone: 603-218-1793
  • Fax: 603-218-1794
Mailing address:
  • Phone: 603-218-1793
  • Fax: 603-218-1794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MICHELLE PATINO
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 833-626-8724