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NPI Code Detail

MEDICARE: ROANOKE SURGERY CENTER, LP

MEDICARE: ROANOKE SURGERY CENTER, LP
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
1261QA1903XAmbulatory Surgical Clinic/CenterOH697VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205869211
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROANOKE SURGERY CENTER, LP
Provider Business Mailing Address
First Line : 1802 BRAEBURN DR
Second Line :
City : SALEM
State : VA
Zip : 24153-7357
Country : US
Telephone Number : 540-725-4533
Fax Number : 540-725-4543
Provider Business Practice Location Address
First Line : 1802 BRAEBURN DR
Second Line :
City : SALEM
State : VA
Zip : 24153-7357
Country : US
Telephone Number : 540-725-4533
Fax Number : 540-725-4543
Authorized Official
Title or Position : VP/CFO
Name : DAVID MCKNIGHT
Credential :
Telephone Number : 972-789-2816
Provider Enumeration Date : 07/10/2006
Last Update Date : 06/09/2026

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Directions to “ROANOKE SURGERY CENTER, LP ” Practice Location

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