Organization
WILLOUGHBY SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID A DEMANGONE M.D. (OWNER)
(440) 944-1414
Entity
Organization
Contact information
Practice address
6025 COMMERCE CIR, SUITE 1, WILLOUGHBY, OH 44094-9668
(440) 585-2750
(440) 944-0868
Mailing address
6025 COMMERCE CIR, SUITE 1, WILLOUGHBY, OH 44094-9668
(440) 585-2750
(440) 944-0868
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3137920
—
OH
01
—
P00829745
RAILROAD MEDICARE
OH
Enumeration date
03/26/2008
Last updated
02/20/2013
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