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General NPI Number Information
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NPI Number | 1396741542
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Entity Type | Organization
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Legal Business Name | BEARWOOD AMBULATORY SURGERY CENTER
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 05/09/2008
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Provider Practice Location Address
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Address Line | 3031 N HIGHWAY 81
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City | ANDERSON
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State | SC
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Zip | 29621-3621
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Country | US
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Telephone | 864-226-7371
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Fax | 864-226-8367
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Provider Business Mailing Address
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Address Line | 3031 N HIGHWAY 81
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City | ANDERSON
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State | SC
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Zip | 29621-3621
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Country | US
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Telephone | 864-226-7371
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Fax | 864-226-8367
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Authorized Official
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Title or Position | NURSE ADMINISTRATOR
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Name | MRS. KATHY D. GIBSON
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Credential | NURSE ADMINISTRATOR
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Telephone | 864-226-7371
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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 | ASF-021
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License Number State | SC
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