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Organization
SPECIAL COMPANY LLC
Active
Organization
SPECIAL COMPANY LLC
Active
Other names
Bayside Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARRY BRAKE M.D. (PRESIDENT)
(508) 540-9771
Entity
Organization
Contact information
Practice address
39 EDGERTON DR, N FALMOUTH, MA 02556-2821
(508) 274-6901
(508) 540-3158
Mailing address
39 EDGERTON DR, N FALMOUTH, MA 02556-2821
(508) 274-6901
(508) 540-3158
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
PENDING
MA
Other
Enumeration date
04/18/2006
Last updated
05/20/2008
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