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General NPI Number Information
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NPI Number | 1558345033
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Entity Type | Organization
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Legal Business Name | SURGERY ALLIANCE LTD
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Dates
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Enumeration Date | 11/30/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 975 SAWBURG AVE
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City | ALLIANCE
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State | OH
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Zip | 44601-3515
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Country | US
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Telephone | 330-821-7997
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Fax | 330-821-7295
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Provider Business Mailing Address
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Address Line | 975 SAWBURG AVE
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City | ALLIANCE
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State | OH
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Zip | 44601-3515
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Country | US
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Telephone | 330-821-7997
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Fax | 330-821-7295
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. HAZEL THOMAS
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Credential |
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Telephone | 330-821-7997
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 0030AS
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License Number State | OH
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