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Organization

AMBULATORY SURGERY CENTER OF NORTHERN OHIO INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JAMES J ANDRASSY (CIO/ADMINISTRATOR)
(440) 646-8585
Entity
Organization

Contact information

Practice address
6801 MAYFIELD RD, SUITE 142, LYNDHURST, OH 44124-2270
(440) 461-8800
(440) 646-8594
Mailing address
5252 MAYFIELD RD, SUITE 142, LYNDHURST, OH 44124-2408
(440) 646-8585
(440) 646-8590

Taxonomy

Speciality
Code
Description
License number
State
261QE0800X
Endoscopy Clinic/Center
Primary
0065AS
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000243661
ANTHEM BCBS & ANTHEM SR
OH
05
0621465
OH
01
7316076
AETNA
OH
Enumeration date
07/15/2005
Last updated
08/22/2020
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