Provider Demographics
NPI:1902134372
Name:METRO SPECIALTY SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:METRO SPECIALTY SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTSHORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-800-2017
Mailing Address - Street 1:200 MISSOURI AVENUE
Mailing Address - Street 2:BUILDING 18
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3061
Mailing Address - Country:US
Mailing Address - Phone:205-266-0283
Mailing Address - Fax:502-742-2509
Practice Address - Street 1:200 MISSOURI AVE
Practice Address - Street 2:BUILDING 18
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3061
Practice Address - Country:US
Practice Address - Phone:205-266-0283
Practice Address - Fax:502-742-2509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-24
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical