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Organization

ST. MARY'S AMBULATORY SURGERY CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SCOTT MONTGOMERY (OFFICER/AUTHORIZED OFFICIAL)
(615) 545-9132
Entity
Organization

Contact information

Practice address
1501 MAPLE AVE, STE 300, RICHMOND, VA 23226-2553
(804) 287-7878
(804) 287-7879
Mailing address
1501 MAPLE AVE, STE 300, RICHMOND, VA 23226-2553
(804) 287-7878
(804) 287-7879

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
OH 702
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1043236664
VA
01
P00380790
RAILROAD MEDICARE
VA
Enumeration date
07/15/2006
Last updated
09/15/2025
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