Organization
COLTON CA MULTI ASC LP
Active
Other names
Premier Outpatient Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFERY SNODGRASS (PRESIDENT)
(615) 665-1283
Entity
Organization
Contact information
Practice address
1003 E BRIER DRIVE, SUITE 170, SAN BERNARDINO, CA 92408-2862
(909) 370-2190
(909) 370-2266
Mailing address
1A BURTON HILLS BLVD., LICENSURE AND CERT DEPT, NASHVILLE, TN 37215-6187
(615) 263-4011
(615) 234-1720
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
CA
Other
Enumeration date
11/29/2012
Last updated
01/20/2023
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