# PARKRIDGE SURGERY CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PARKRIDGE SURGERY CENTER LLC
- **Other names:** Parkridge Surgery Center LLC CRNA
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1780998633
- **Legal business name:** PARKRIDGE SURGERY CENTER LLC
- **Authorized official:** EMILIE M KEENE (ADMINISTRATOR)
- **Authorized official phone:** (803) 407-4950

## Contact information

- **Practice address:** 190 PARKRIDGE DR STE 108, COLUMBIA, SC 29212-1748
- **Practice address phone:** (803) 296-2548
- **Practice address fax:** (803) 296-2548
- **Mailing address:** 190 PARKRIDGE DR STE 108, COLUMBIA, SC 29212-1748
- **Mailing address phone:** (803) 296-2548
- **Mailing address fax:** (803) 296-2548

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | ASF-078 | SC | Yes |

## Other

- **Enumeration date:** 08/03/2010
- **Last updated:** 08/03/2010