MEDICARE: ROSWELL SURGERY CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1154027654
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROSWELL SURGERY CENTER LLC

Provider Business Mailing Address
First Line	:	1400 W COUNTRY CLUB RD
Second Line	:
City	:	ROSWELL
State	:	NM
Zip	:	88201-5256
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 WEST COUNTRY CLUB RD
Second Line	:
City	:	ROSWELL
State	:	NM
Zip	:	88201
Country	:	US
Telephone Number	:	575-623-9101
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR/OWNER
Name	:	OMAR OSMANI
Credential	:	MD
Telephone Number	:	575-623-9101

Provider Enumeration Date	:	02/06/2023
Last Update Date	:	04/10/2026

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Directions to “ROSWELL SURGERY CENTER LLC ” Practice Location

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