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Organization
LEBANON ENDOSCOPY CENTER LLC
Active
Organization
LEBANON ENDOSCOPY CENTER LLC
Active
Other names
Lebanon Endoscopy Center
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTEN OCONNOR (OFFICER/AUTHORIZED OFFICIAL)
(615) 376-7315
Entity
Organization
Contact information
Practice address
100 PHYSICIANS WAY, SUITE 340, LEBANON, TN 37090-8103
(615) 446-9532
(615) 466-9536
Mailing address
100 PHYSICIANS WAY, SUITE 340, LEBANON, TN 37090-8103
(615) 446-9532
(615) 466-9536
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
261QE0800X
Endoscopy Clinic/Center
PENDING
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518492
—
TN
01
—
P00649646
RAILROAD MEDICARE
TN
Enumeration date
09/12/2006
Last updated
10/11/2024
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