Organization
HHC SOUTHINGTON SURGERY CENTER, LLC
Active
Other names
Cheshire Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
LUCILLE FORMEISTER (DIRECTOR BUSINESS SYSTEMS)
(860) 667-9542
Entity
Organization
Contact information
Practice address
765 WEST JOHNSON AVENUE, CHESHIRE, CT 06410
(860) 378-8228
Mailing address
PO BOX 956, AVON, CT 06001
(860) 667-2066
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0341
STATE OF CONNECTICUT LICENSE
CT
Enumeration date
05/12/2014
Last updated
09/21/2021
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