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General NPI Number Information
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NPI Number | 1215978945
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Entity Type | Organization
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Legal Business Name | SAPLING GROVE AMBULATORY SURGERY CENTER, LLC
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 06/06/2018
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Provider Practice Location Address
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Address Line | 240 MEDICAL PARK BLVD STE 2400
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City | BRISTOL
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State | TN
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Zip | 37620-7346
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Country | US
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Telephone | 423-990-2470
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Fax | 423-990-2471
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Provider Business Mailing Address
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Address Line | PO BOX 449
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City | KINGSPORT
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State | TN
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Zip | 37662-0449
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Country | US
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Telephone | 423-990-2470
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Fax | 423-990-2471
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Authorized Official
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Title or Position | COMPTROLLER
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Name | SHAWNA ARMSTRONG
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Credential |
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Telephone | 423-857-2008
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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 | 0116
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License Number State | TN
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