Healthcare Provider Details

I. General information

NPI: 1588656508
Provider Name (Legal Business Name): SAINT THOMAS CAMPUS SURGICARE LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4230 HARDING PIKE PLAZA EAST, SUITE 300
NASHVILLE TN
37205-2013
US

IV. Provider business mailing address

4230 HARDING PIKE PLAZA EAST, SUITE 300
NASHVILLE TN
37205-2013
US

V. Phone/Fax

Practice location:
  • Phone: 615-783-1260
  • Fax: 615-783-1261
Mailing address:
  • Phone: 615-783-1261
  • Fax: 615-783-1261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number0000000143
License Number StateTN

VIII. Authorized Official

Name: KRISTEN O'CONNOR
Title or Position: OFFICER / AUTHORIZED OFFICIAL
Credential:
Phone: 615-376-7315