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General NPI Number Information
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NPI Number | 1649462409
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Entity Type | Organization
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Legal Business Name | OHIO VALLEY AMBULATORY SURGERY CENTER, LLC
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Dates
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Enumeration Date | 08/15/2007
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Last Update Date | 10/21/2008
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Provider Practice Location Address
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Address Line | 608 WASHINGTON BLVD
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City | BELPRE
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State | OH
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Zip | 45714-2465
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Country | US
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Telephone | 740-423-4684
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Fax | 740-423-4694
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Provider Business Mailing Address
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Address Line | 608 WASHINGTON BLVD
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City | BELPRE
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State | OH
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Zip | 45714-2465
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Country | US
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Telephone | 740-423-4684
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Fax | 740-423-4694
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID CATALINO MENDOZA
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Credential | MD
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Telephone | 304-615-0655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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