Organization
PROVIDENCE SURGERY CENTERS LLC
Active
Other names
Creekside Surgical Center
Organization subpart
No
Provider details
NPI number
Authorized official
COLLEEN M BRIDGE (SECRETARY, BOARD OF MANAGERS)
(907) 212-3035
Entity
Organization
Contact information
Practice address
3831 PIPER ST. SUITE S-110, ANCHORAGE, AK 99508
(907) 339-7800
(315) 571-9944
Mailing address
PO BOX 233889, ANCHORAGE, AK 99523-3889
(907) 212-3035
(315) 571-9944
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
PENDING
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000000
PENDING MEDICARE #
AK
Enumeration date
06/10/2010
Last updated
06/10/2010
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