Healthcare Provider Details

I. General information

NPI: 1760473425
Provider Name (Legal Business Name): BECKLEY SURGERY CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 BROOKSHIRE LN
BECKLEY WV
25801-6765
US

IV. Provider business mailing address

84 BROOKSHIRE LN
BECKLEY WV
25801-6765
US

V. Phone/Fax

Practice location:
  • Phone: 304-255-2724
  • Fax: 304-255-3691
Mailing address:
  • Phone: 304-255-2724
  • Fax: 304-255-3691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number1351
License Number StateWV

VIII. Authorized Official

Name: JOSEPH JEFFERDS SINCLAIR
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 304-343-3937