Provider Demographics
NPI:1306527403
Name:SAAK AMBULATORY SURGERY CENTER LLC
Entity type:Organization
Organization Name:SAAK AMBULATORY SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAMAGOPAL
Authorized Official - Middle Name:
Authorized Official - Last Name:TUMULURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:414-649-3530
Mailing Address - Street 1:18200 W CAPITOL DR
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-1445
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18200 W CAPITOL DR STE 100
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-1445
Practice Address - Country:US
Practice Address - Phone:262-444-5149
Practice Address - Fax:262-444-5459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory SurgicalGroup - Single Specialty