Healthcare Provider Details

I. General information

NPI: 1770582488
Provider Name (Legal Business Name): AMBULATORY SURGERY CENTER OF NORTHERN OHIO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 MAYFIELD RD SUITE 142
LYNDHURST OH
44124-2270
US

IV. Provider business mailing address

5252 MAYFIELD RD SUITE 142
LYNDHURST OH
44124-2408
US

V. Phone/Fax

Practice location:
  • Phone: 440-461-8800
  • Fax: 440-646-8594
Mailing address:
  • Phone: 440-646-8585
  • Fax: 440-646-8590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number0065AS
License Number StateOH

VIII. Authorized Official

Name: MR. JAMES J ANDRASSY
Title or Position: CIO/ADMINISTRATOR
Credential:
Phone: 440-646-8585