Provider Demographics
NPI:1588876817
Name:FREEWAY SURGERY CENTER LLC
Entity type:Organization
Organization Name:FREEWAY SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHLESINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-661-0077
Mailing Address - Street 1:5800 WEST TENTH STREET
Mailing Address - Street 2:SUITE 206
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5800 WEST TENTH STREET
Practice Address - Street 2:SUITE 206
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204
Practice Address - Country:US
Practice Address - Phone:501-661-0077
Practice Address - Fax:501-907-5238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR11077Medicare PIN
AR04C0001077Medicare Oscar/Certification