Organization
TRI-STATE SURGERY CENTER, L.L.C.
Active
Other names
Dubuque Regional Ambulatory Surgical Center, L.L.C.
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA ANN PERLETH (BUSINESS OFFICE MANAGER)
(563) 584-4506
Entity
Organization
Contact information
Practice address
1500 ASSOCIATES DR, DUBUQUE, IA 52002-2201
(563) 584-4536
(563) 584-4526
Mailing address
1500 ASSOCIATES DR, DUBUQUE, IA 52002-2201
(563) 584-4536
(563) 584-4526
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
261QA1903X
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0610139
—
IA
01
—
61010
BC/BS PROVIDER NUMBER
IA
Enumeration date
07/05/2005
Last updated
05/31/2012
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