MEDICARE: BECKLEY SURGERY CENTER, INC

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	1351	WV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	490004321	OTHER	WV	RAILROAD MEDICARE NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1047629	OTHER	WV	WORKERS COMP PROV #
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	000394182	OTHER	WV	BCBS PAY TO ID

General Provider Information

NPI Number	:	1760473425
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BECKLEY SURGERY CENTER, INC

Provider Business Mailing Address
First Line	:	84 BROOKSHIRE LN
Second Line	:
City	:	BECKLEY
State	:	WV
Zip	:	25801-6765
Country	:	US
Telephone Number	:	304-255-2724
Fax Number	:	304-255-3691

Provider Business Practice Location Address
First Line	:	84 BROOKSHIRE LN
Second Line	:
City	:	BECKLEY
State	:	WV
Zip	:	25801-6765
Country	:	US
Telephone Number	:	304-255-2724
Fax Number	:	304-255-3691

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	JOSEPH JEFFERDS SINCLAIR
Credential	:
Telephone Number	:	304-343-3937

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	05/19/2025

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Directions to “BECKLEY SURGERY CENTER, INC ” Practice Location

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