Provider Demographics
NPI:1972286037
Name:GSU SURGERY CENTER, INC
Entity type:Organization
Organization Name:GSU SURGERY CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHRUPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-768-2890
Mailing Address - Street 1:400 PLAZA DR STE 140
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-4746
Mailing Address - Country:US
Mailing Address - Phone:916-768-2890
Mailing Address - Fax:530-758-3324
Practice Address - Street 1:530 PLAZA DR STE 110
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-4782
Practice Address - Country:US
Practice Address - Phone:916-235-6802
Practice Address - Fax:916-221-7783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical