Organization
GRANTS PASS SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULIE ANN DEGER (OFFICE MANAGER)
(541) 472-4884
Entity
Organization
Contact information
Practice address
1601 NW HAWTHORNE AVE, GRANTS PASS, OR 97526-1041
(541) 472-4880
(541) 472-4899
Mailing address
1601NW HAWTHORNE AVE, GRANTS PASS, OR 97526-1041
(541) 472-4880
(541) 472-4899
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0504365
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165232
—
OR
Enumeration date
07/26/2005
Last updated
01/03/2008
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