Lander Valley Ambulatory Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

LANDER VALLEY AMBULATORY SURGERY CENTER LLC

Doing business as

Lander Outpatient Surgical Center

Practice address

1320 Bishop Randall Dr
Lander, WY 82520-3939

Phone

(307) 335-6565

Fax

(307) 335-6566

NPI assigned

Oct 1, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Donald J. Bivacca

Title

President

Phone

(615) 372-8500

Specialties & licenses 1

Addresses

Other names 1

• Lander Outpatient Surgical Center Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Community Hospital of Andalusia LLC

  dba Florala Health Clinic

  • Family Medicine Physician
  • Florala, AL
  • NPI 1437684305

  Member Of

  NPD member

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380758400000",
    "number": "1457548711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 POWELL CT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275079",
            "telephone_number": "615-372-8500",
            "fax_number": "615-372-8572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 BISHOP RANDALL DR",
            "city": "LANDER",
            "state": "WY",
            "postal_code": "825203939",
            "telephone_number": "307-335-6565",
            "fax_number": "307-335-6566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANDER VALLEY AMBULATORY SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2013-10-03",
        "status": "A",
        "authorized_official_last_name": "BIVACCA",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-372-8500"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lander Outpatient Surgical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lander Family Medicine, P.C.
• Lander Labs LLC
• Lander Medical Clinic, P.C.
• Lander Medical Clinic, PC
• Lander Regional Hospital
• Lander Valley Family Practice PC
• Lander Valley Medical Center LLC (Lander Valley Medical Center Hospitalists)
• Lander Valley Medical Center LLC (Lander Regional Hospital)
• Lander Valley Medical Center LLC
• Lander Valley Medical Center LLC (Lander Regional Hospital)

• Ambulatory Surgical Clinic/Center in Lander, WY
• Providers in Lander, WY by specialty
• Ambulatory Surgical Clinic/Center in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.