Organization
LAKE CUMBERLAND SURGERY CENTER LP
Active
Other names
Lake Cumberland Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
TERRANCE DILLON (ASSISTANT SECRETARY)
(502) 596-7220
Entity
Organization
Contact information
Practice address
301 LANGDON ST, SOMERSET, KY 42503-2750
(606) 678-9688
(606) 679-7479
Mailing address
330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-4536
(615) 920-7000
(615) 920-8913
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
300141
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000288161
BCBS
KY
05
—
36001246
—
KY
01
—
P00000869
RAILROAD MEDICARE ASC
KY
Enumeration date
12/27/2006
Last updated
04/25/2022
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