=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295163715
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BLUFFTON OKATIE SURGERY CENTER, L.L.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/18/2013
-----------------------------------------------------
Last Update Date | 02/18/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 40 OKATIE CENTER BLVD S SUITE 125
-----------------------------------------------------
City | OKATIE
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29909-7507
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-705-8804
-----------------------------------------------------
Fax | 843-705-8950
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 40 OKATIE CENTER BLVD S SUITE 125
-----------------------------------------------------
City | OKATIE
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29909-7507
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-705-8851
-----------------------------------------------------
Fax | 843-705-8950
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | AUTHORIZED OFFICIAL
-----------------------------------------------------
Name | COLLIN LEMAISTRE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 214-213-0723
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA1903X
-----------------------------------------------------
Taxonomy Name | Ambulatory Surgical Clinic/Center
-----------------------------------------------------
License Number | ASF-0075
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------