1477617751 NPI number — COLUMBIA SURGICAL SPECIALISTS, PS

Table of content: (NPI 1477617751)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477617751 NPI number — COLUMBIA SURGICAL SPECIALISTS, PS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COLUMBIA SURGICAL SPECIALISTS, PS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
COLUMBIA SURGERY CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477617751
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/09/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2242
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPOKANE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99210-2242
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-624-2326
Provider Business Mailing Address Fax Number:
509-789-5702

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
217 W CATALDO
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-624-2326
Provider Business Practice Location Address Fax Number:
509-252-2837
Provider Enumeration Date:
12/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
EMERSON
Authorized Official First Name:
ROD
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
509-624-2326

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  ASF.FS.60099962 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 50C0001176 . This is a "MEDICARE ASC CERTIFICATION" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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