Provider Demographics
NPI:1962057497
Name:CLEARWAY SURGERY CENTER OF MOBILE
Entity type:Organization
Organization Name:CLEARWAY SURGERY CENTER OF MOBILE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHLEMBACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-439-5425
Mailing Address - Street 1:PO BOX 11637
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32524-1637
Mailing Address - Country:US
Mailing Address - Phone:850-484-4080
Mailing Address - Fax:850-484-8801
Practice Address - Street 1:855 DOWNTOWNER BLVD STE A
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-5403
Practice Address - Country:US
Practice Address - Phone:850-484-4080
Practice Address - Fax:850-484-8801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-01
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical