LEBONHEUR EAST SURGERY CENTER II LP


Address: 786 Estate Place, Memphis, TN 38120
Phone: 9012874100

LEBONHEUR EAST SURGERY CENTER II LP (NPI# 1073763652) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1073763652
Entity Type Organization
Organization Name LEBONHEUR EAST SURGERY CENTER II LP
Other Organization Name LEBONHEUR EAST SURGERY CENTER LP
Practice Address 786 Estate Place
Memphis
TN 38120
Practice Telephone 9012874100
Practice Fax Number 9015161755
Mailing Telephone 9012874100
Mailing Fax Number 9015161755
Enumeration Date 2008-09-19
Last Update Date 2012-02-01
Authorized Official Name MRS. SHERRYE B CRONE (ADMINISTRATOR)
Authorized Official Telephone 9015161716
Authorized Official Credential RN
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QA1903X Clinic/Center
Specialization: Ambulatory Surgical
0000000042 TN Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
TN BLUE CROSS/BLUE SHIELD 0117229 01

Other Provider/Organization Names

Other Name Type Code
LeBonheur East Surgery Center LP Former Legal Business Name - Organization

Office Location

Street Address 786 ESTATE PLACE
City MEMPHIS
State TN
Zip Code 38120

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1376962613 John Christopher Swearingen Dentist 780 Ridge Lake Blvd Ste 101, Memphis, TN 38120 2014-04-15
1275884645 Rebecca Leigh Goedecke Nurse Practitioner 6215 Humphreys Blvd Ste 301, Memphis, TN 38120 2012-09-26
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Taxonomy Information

Taxonomy Code 261QA1903X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Ambulatory Surgical

Taxonomy Definition

Definition to come...

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Competitor

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City MEMPHIS
Zip Code 38120

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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