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General NPI Number Information
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NPI Number | 1013914985
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Entity Type | Organization
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Legal Business Name | ROANOKE AMBULATORY SURGERY CENTER, LLC
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Dates
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Enumeration Date | 07/06/2005
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 1102 S JEFFERSON ST
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City | ROANOKE
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State | VA
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Zip | 24016-4704
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Country | US
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Telephone | 540-342-5800
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Fax |
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Provider Business Mailing Address
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Address Line | 1102 S JEFFERSON ST
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City | ROANOKE
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State | VA
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Zip | 24016-4704
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Country | US
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Telephone | 540-342-5800
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | THOMAS K MILLER
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Credential | M.D.
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Telephone | 540-342-0707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | OH636
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License Number State | VA
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