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General NPI Number Information
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NPI Number | 1417993494
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Entity Type | Organization
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Legal Business Name | CONCORD AMBULATORY SURGERY CENTER, LLC
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 60 COMMERCIAL ST SUITE 301
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City | CONCORD
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State | NH
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Zip | 03301-5071
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Country | US
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Telephone | 603-415-9460
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Fax | 603-415-9465
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Provider Business Mailing Address
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Address Line | 60 COMMERCIAL ST SUITE 301
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City | CONCORD
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State | NH
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Zip | 03301-5071
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Country | US
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Telephone | 603-415-9460
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Fax | 603-415-9465
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL OF CORPORATION
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Name | MR. BRUCE BURNS
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Credential |
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Telephone | 603-227-7000
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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 | 03034
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License Number State | NH
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