Healthcare Provider Details
I. General information
NPI: 1215227194
Provider Name (Legal Business Name): SOUTH HILLS SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/13/2011
Last Update Date: 10/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6161 CLAIRTON RD
WEST MIFFLIN PA
15122-2475
US
IV. Provider business mailing address
6161 CLAIRTON RD
WEST MIFFLIN PA
15122-2475
US
V. Phone/Fax
- Phone: 412-714-4951
- Fax:
- Phone: 412-714-4951
- Fax:
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:
TIMOTHY
HONKALA
Title or Position: CEO
Credential: M.D.
Phone: 412-714-4951