Provider Demographics
NPI:1962215434
Name:ASCENT MEDICAL LLC
Entity type:Organization
Organization Name:ASCENT MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:
Authorized Official - Last Name:SMOLARZ
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:340-514-0440
Mailing Address - Street 1:7148 ESTATE MAFOLIE
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802-3680
Mailing Address - Country:US
Mailing Address - Phone:340-514-0440
Mailing Address - Fax:
Practice Address - Street 1:7148 ESTATE MAFOLIE
Practice Address - Street 2:
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-3680
Practice Address - Country:US
Practice Address - Phone:340-514-0440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty