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General NPI Number Information
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NPI Number | 1437148681
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Entity Type | Organization
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Legal Business Name | REGIONAL AMBULATORY SURGERY CENTER, LLC
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Dates
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Enumeration Date | 10/20/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1376 BUCKTAIL RD
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City | ST MARYS
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State | PA
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Zip | 15857-3212
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Country | US
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Telephone | 814-781-6565
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Fax | 814-781-1985
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Provider Business Mailing Address
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Address Line | 1376 BUCKTAIL RD
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City | ST MARYS
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State | PA
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Zip | 15857-3212
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Country | US
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Telephone | 814-781-6565
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Fax | 814-781-1985
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. K.C. JOSEPH
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Credential | M.D.
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Telephone | 814-781-6565
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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 | 15531501
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License Number State | PA
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