# BLACK ROCK SURGERY CENTER LLC

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

## Provider details

- **NPI number:** 1669039640
- **Authorized official:** MR. MARK G MURPHY (OWNER)
- **Authorized official phone:** (307) 358-6200

## Contact information

- **Practice address:** 2901 POWDER BASIN AVE, GILLETTE, WY 82718-6406
- **Practice address phone:** (307) 682-6222
- **Practice address fax:** (307) 682-6999
- **Mailing address:** PO BOX 688, DOUGLAS, WY 82633-0688
- **Mailing address phone:** (307) 358-6200
- **Mailing address fax:** (307) 358-3748

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 05/24/2019
- **Last updated:** 05/24/2019