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General NPI Number Information
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NPI Number | 1528479664
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Entity Type | Organization
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Legal Business Name | HHC SOUTHINGTON SURGERY CENTER, LLC
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Dates
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Enumeration Date | 05/12/2014
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Last Update Date | 09/21/2021
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Provider Practice Location Address
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Address Line | 765 WEST JOHNSON AVENUE
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City | CHESHIRE
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State | CT
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Zip | 06410
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Country | US
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Telephone | 860-378-8228
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 956
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City | AVON
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State | CT
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Zip | 06001
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Country | US
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Telephone | 860-667-2066
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Fax |
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Authorized Official
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Title or Position | DIRECTOR BUSINESS SYSTEMS
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Name | LUCILLE FORMEISTER
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Credential |
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Telephone | 860-667-9542
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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 |
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License Number State |
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