Healthcare Provider Details
I. General information
NPI: 1184699233
Provider Name (Legal Business Name): LAWRENCE COUNTY SURGERY CENTER, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2 E LAUREL AVE
NEW CASTLE PA
16101-2354
US
IV. Provider business mailing address
2 E LAUREL AVE
NEW CASTLE PA
16101-2354
US
V. Phone/Fax
- Phone: 724-656-9181
- Fax: 724-656-1340
- Phone: 724-656-9181
- Fax: 724-656-1340
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
EDWARD
G
REDOVAN
Title or Position: CHAIRMAN OF THE BOARD
Credential: M.D.
Phone: 724-656-9181