Provider Demographics
NPI:1386736668
Name:PARK WEST SURGICAL CENTER, LLC
Entity type:Organization
Organization Name:PARK WEST SURGICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:FINLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:330-864-6000
Mailing Address - Street 1:1 PARK WEST BLVD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-4218
Mailing Address - Country:US
Mailing Address - Phone:330-864-6000
Mailing Address - Fax:330-864-6020
Practice Address - Street 1:1 PARK WEST BLVD
Practice Address - Street 2:SUITE 260
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-4218
Practice Address - Country:US
Practice Address - Phone:330-864-6000
Practice Address - Fax:330-864-6020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0794AS261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3612121Medicare PIN