Healthcare Provider Details

I. General information

NPI: 1699254169
Provider Name (Legal Business Name): WESTMORELAND ASC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2018
Last Update Date: 03/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5325 STATE ROUTE 233
WESTMORELAND NY
13490-1322
US

IV. Provider business mailing address

5325 STATE ROUTE 233
WESTMORELAND NY
13490-1322
US

V. Phone/Fax

Practice location:
  • Phone: 315-801-5060
  • Fax:
Mailing address:
  • Phone: 315-801-5060
  • Fax:

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: TIM SCANLON
Title or Position: CEO
Credential:
Phone: 315-801-5060