Provider Demographics
NPI:1699254169
Name:WESTMORELAND ASC, LLC
Entity type:Organization
Organization Name:WESTMORELAND ASC, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SCANLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-801-5060
Mailing Address - Street 1:5325 STATE ROUTE 233
Mailing Address - Street 2:
Mailing Address - City:WESTMORELAND
Mailing Address - State:NY
Mailing Address - Zip Code:13490-1322
Mailing Address - Country:US
Mailing Address - Phone:315-801-5060
Mailing Address - Fax:
Practice Address - Street 1:5325 STATE ROUTE 233
Practice Address - Street 2:
Practice Address - City:WESTMORELAND
Practice Address - State:NY
Practice Address - Zip Code:13490-1322
Practice Address - Country:US
Practice Address - Phone:315-801-5060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WESTMORELAND ASC LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-07
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty