# SOUTH COAST SURGERY CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205889110
- **Authorized official:** MR. CHRISTOPHER CLARKE (CLINIC ADMINISTRATOR)
- **Authorized official phone:** (541) 266-3600

## Contact information

- **Practice address:** 2699 N 17TH ST, COOS BAY, OR 97420
- **Practice address phone:** (541) 266-3600
- **Practice address fax:** (541) 269-0708
- **Mailing address:** 2699 N 17TH ST, A, COOS BAY, OR 97420
- **Mailing address phone:** (541) 266-3600
- **Mailing address fax:** (541) 269-0708

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/19/2006
- **Last updated:** 11/18/2008