Organization
SOUTH CENTRAL SURGICAL CENTER, LLC
Active
Other names
Center for Specialty Care
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA LYNN THOMPSON (REVENUE CYCLE MANAGER)
(307) 277-9668
Entity
Organization
Contact information
Practice address
717 S STATE ST, SUITE 1000, FAIRMONT, MN 56031-4469
(507) 235-3939
Mailing address
717 S STATE ST, SUITE 1000, FAIRMONT, MN 56031-4469
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1022719
PREFERREDONE
MN
01
—
127628
UCARE
MN
01
—
139026400
US DEPT OF LABOR
—
01
—
28772
SANFORD
—
05
—
528471
—
IA
01
—
5C58SO
BLUE CROSS BLUE SHIELD
MN
05
—
716185900
—
MN
01
—
F250619
MIDLANDS CHOICE
—
Enumeration date
05/02/2006
Last updated
10/04/2022
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