Provider Demographics
NPI:1194239483
Name:ATLANTIC COAST SURGICAL SUITES, LLC
Entity type:Organization
Organization Name:ATLANTIC COAST SURGICAL SUITES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-609-1168
Mailing Address - Street 1:325-2 LAFAYETTE RD
Mailing Address - Street 2:
Mailing Address - City:SEABROOK
Mailing Address - State:NH
Mailing Address - Zip Code:03874-4539
Mailing Address - Country:US
Mailing Address - Phone:603-218-1793
Mailing Address - Fax:603-218-1794
Practice Address - Street 1:325-2 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:SEABROOK
Practice Address - State:NH
Practice Address - Zip Code:03874-4539
Practice Address - Country:US
Practice Address - Phone:603-218-1793
Practice Address - Fax:603-218-1794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-22
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical