Healthcare Provider Details

I. General information

NPI: 1629095195
Provider Name (Legal Business Name): SURGICENTER AT LIGONIER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 W MAIN ST
LIGONIER PA
15658
US

IV. Provider business mailing address

PO BOX 1100
LATROBE PA
15650-5011
US

V. Phone/Fax

Practice location:
  • Phone: 724-238-9573
  • Fax: 724-832-4468
Mailing address:
  • Phone: 724-238-9573
  • Fax: 724-832-4468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberASF 6340
License Number StatePA

VIII. Authorized Official

Name: MR. JEFFREY T CURRY
Title or Position: EXECUTIVE VICE PRESIDENT CFO
Credential:
Phone: 724-832-4030