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General NPI Number Information
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NPI Number | 1174500904
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Entity Type | Organization
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Legal Business Name | CENTER FOR SPECIAL SURGERY
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 10/07/2010
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Provider Practice Location Address
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Address Line | 209 PATEWOOD DRIVE SUITE 300
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City | GREENVILLE
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State | SC
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Zip | 29615-3581
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Country | US
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Telephone | 864-527-7700
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Fax | 864-527-7701
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Provider Business Mailing Address
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Address Line | 209 PATEWOOD DRIVE SUITE 300
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City | GREENVILLE
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State | SC
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Zip | 29615-3581
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Country | US
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Telephone | 864-527-7700
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Fax | 864-527-7701
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. ASHLEY BROWN
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Credential |
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Telephone | 864-527-7700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | ASF067DHEC
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | ASF-0067
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License Number State | SC
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