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General NPI Number Information
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NPI Number | 1750948873
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Entity Type | Organization
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Legal Business Name | ERIE SHORES SURGERY CENTER LLC
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Dates
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Enumeration Date | 05/23/2019
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Last Update Date | 09/16/2022
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Provider Practice Location Address
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Address Line | 2800 HAYES AVE BLDG E
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City | SANDUSKY
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State | OH
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Zip | 44870-7255
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Country | US
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Telephone | 419-627-8557
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Fax |
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Provider Business Mailing Address
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Address Line | 2800 HAYES AVE BLDG E
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City | SANDUSKY
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State | OH
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Zip | 44870-7255
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ROBERT MOORE
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Credential |
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Telephone | 419-627-8557
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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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