Organization
CLEVELAND ASC LLC
Active
Other names
Cleveland Surgical Suites
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES WACHTER (CHIEF MEDICAL OFFICER)
(636) 227-2600
Entity
Organization
Contact information
Practice address
5106 WILSON MILLS RD, RICHMOND HEIGHTS, OH 44143-3006
(440) 461-2570
(440) 461-7109
Mailing address
15933 CLAYTON RD STE 210, BALLWIN, MO 63011-2172
(636) 227-2600
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0448AS
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2060639
—
OH
01
—
490003603
RAILROAD MEDICARE
OH
Enumeration date
01/20/2006
Last updated
04/20/2023
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