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General NPI Number Information
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NPI Number | 1750386918
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Entity Type | Organization
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Legal Business Name | MIDTOWN SURGERY CENTER LP
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Dates
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Enumeration Date | 06/15/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 255 S PAULINE ST
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City | MEMPHIS
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State | TN
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Zip | 38104
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Country | US
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Telephone | 901-527-6871
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Fax | 901-527-6873
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Provider Business Mailing Address
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Address Line | 255 S PAULINE ST
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City | MEMPHIS
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State | TN
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Zip | 38104
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Country | US
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Telephone | 901-527-6871
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Fax | 901-527-6873
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Authorized Official
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Title or Position | FACILITY ADMINISTRATOR
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Name | MARCIA B VAN ALSTINE
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Credential | RN CNOR
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Telephone | 901-527-6871
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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 | TN
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