Eastland Medical Plaza Surgicenter, Llc

LBN: Eastland Medical Plaza Surgicenter, Llc
Eastland Medical Plaza Surgicenter, Llc is an health care organization with primary practice located at 1505 Eastland Dr , Bloomington IL 61701-3534. The organization recently has only one registered license in Ambulatory Health Care Facilities / Ambulatory Surgical, which is considered as the primary health care specialty. Eastland Medical Plaza Surgicenter, Llc can be contacted via phone (309) 663-1997, or through Frye, Jackie Ann via phone (309) 663-1997.

Contact Information

Primary practice address
1505 Eastland Dr Bloomington IL 61701-3534
Phone: (309) 663-1997
Fax: (309) 662-9527
Website:
Map and Directions
Authorized official contact:
Name: Frye, Jackie Ann
Phone: (309) 663-1997

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Ambulatory Surgical 261QA1903X 7002413 Illinois

Profile Details

NPI number 1699751289
LBN Legal business name Eastland Medical Plaza Surgicenter, Llc
DBA Doing business as
Authorized official Frye, Jackie Ann
Entity Organization
Organization subpart 1 No
Enumeration date Dec 16th, 2005
Last updated Jan 6th, 2010 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699751289 NPPES
Illinois Other 7002413 STATE LICENSE

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