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General NPI Number Information
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NPI Number | 1124098512
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Entity Type | Organization
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Legal Business Name | WESMARK AMBULATORY SURGERY CENTER
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Dates
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Enumeration Date | 01/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 420 W WESMARK BLVD
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City | SUMTER
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State | SC
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Zip | 29150-1983
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Country | US
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Telephone | 803-905-5590
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Fax | 803-905-5595
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Provider Business Mailing Address
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Address Line | 420 W WESMARK BLVD
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City | SUMTER
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State | SC
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Zip | 29150-1983
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Country | US
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Telephone | 803-905-5590
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Fax | 803-905-5595
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ROBERT E LEE
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Credential | MD
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Telephone | 803-905-5590
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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 | 05 15999
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License Number State | SC
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