MEDICARE: LAWRENCE 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	S023002	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	144083900	OTHER	KS	US DEPT OF LABOR
2	1511	OTHER	KS	FEDERAL BCBS PROV. #
3	390320	OTHER	KS	FIRSTGUARD PROV. #
4	130326	OTHER	KS	BCBS KS PROV. #
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	90932017	OTHER	KS	BCBS KC PROV. #

General Provider Information

NPI Number	:	1346243680
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAWRENCE SURGERY CENTER LLC

Provider Business Mailing Address
First Line	:	6265 ROCK CHALK DR
Second Line	:	SUITE 2100
City	:	LAWRENCE
State	:	KS
Zip	:	66049-5232
Country	:	US
Telephone Number	:	785-832-0588
Fax Number	:	785-832-2029

Provider Business Practice Location Address
First Line	:	6265 ROCK CHALK DR
Second Line	:	STE 2100
City	:	LAWRENCE
State	:	KS
Zip	:	66049-5232
Country	:	US
Telephone Number	:	785-832-0588
Fax Number	:	785-832-2029

Authorized Official
Title or Position	:	BUSINESS OFFICE MANAGER
Name	:	MRS. LEISA WRIGHT
Credential	:
Telephone Number	:	785-832-0588

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	10/05/2020

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Directions to “LAWRENCE SURGERY CENTER LLC ” Practice Location

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