Provider Demographics
NPI:1861444838
Name:LAS CRUCES SURGERY CENTER LP
Entity type:Organization
Organization Name:LAS CRUCES SURGERY CENTER LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AO- DIRECTOR, PROVIDER ENROLLMENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-465-7377
Mailing Address - Street 1:4351 E LOHMAN AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-8259
Mailing Address - Country:US
Mailing Address - Phone:505-532-3300
Mailing Address - Fax:505-532-3313
Practice Address - Street 1:4351 E LOHMAN AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-8259
Practice Address - Country:US
Practice Address - Phone:505-532-3300
Practice Address - Fax:505-532-3313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3151261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00173972OtherMEDICARE RAILROAD
NM33125864Medicaid