# PROVIDENCE SURGERY CENTERS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Creekside Surgical Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710207998
- **Authorized official:** COLLEEN M BRIDGE (SECRETARY, BOARD OF MANAGERS)
- **Authorized official phone:** (907) 212-3035

## Contact information

- **Practice address:** 3831 PIPER ST. SUITE S-110, ANCHORAGE, AK 99508
- **Practice address phone:** (907) 339-7800
- **Practice address fax:** (315) 571-9944
- **Mailing address:** PO BOX 233889, ANCHORAGE, AK 99523-3889
- **Mailing address phone:** (907) 212-3035
- **Mailing address fax:** (315) 571-9944

## Taxonomy

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

## Other

- **Enumeration date:** 06/10/2010
- **Last updated:** 06/10/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000000 | PENDING MEDICARE \# | AK |