LANDER OUTPATIENT SURGICAL CENTER – NPI #1457548711
Clinic/Center

LANDER OUTPATIENT SURGICAL CENTER is an AHC clinic located in LANDER, WY. NPPES has assigned the NPI number 1457548711 to LANDER OUTPATIENT SURGICAL CENTER on October 01, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “LANDER OUTPATIENT SURGICAL CENTER” is a dba name, the actual legal business name for this organization is LANDER VALLEY AMBULATORY SURGERY CENTER LLC. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was previously updated about 13 years ago on Oct 03, 2013. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for LANDER OUTPATIENT SURGICAL CENTER below.

NPI Profile for
LANDER VALLEY AMBULATORY SURGERY CENTER LLC

NPI Number
1457548711
Enumeration Date

(more than 18 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
LANDER VALLEY AMBULATORY SURGERY CENTER LLC
Doing Business As (dba): LANDER OUTPATIENT SURGICAL CENTER
Primary location
1320 BISHOP RANDALL DR
LANDER, WY 82520-3939
Phone: (307) 335-6565 Fax: (307) 335-6566
Mailing address
103 POWELL CT
BRENTWOOD, TN 37027-5079
Phone: (615) 372-8500 Fax: (615) 372-8572
Organization Subpart
No
Authorized Official
DONALD BIVACCA
PRESIDENT
Phone: (615) 372-8500
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.