Vineyard Surgery Center, LLC
Organization Active NPI Ambulatory Surgical Clinic/Center · Vineyard, UT
NPI 1821759705 · NPPES record last updated Feb 15, 2023
Key facts
- NPI
- 1821759705
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulatory Surgical Clinic/Center 261QA1903X
- Legal business name
- VINEYARD SURGERY CENTER, LLC
- Practice address
- 691 E 400 N Ste 100
Vineyard, UT 84059-7509 - Phone
- (385) 327-0930
- Fax
- (385) 327-0931
- NPI assigned
- Jan 4, 2022
- Organization subpart
- No
Authorized official
- Name
- Ryan Lecheminant
- Title
- Administrator
- Phone
- (385) 203-0246
Subparts reporting this organization as parent 1
Corporate family (same tax ID) 1
Practitioners 2
-
Eric David Freeman, M.D.
Medicare Care Compare: Ambulatory surgical center
- Listed as
- Vineyard Surgery Center LLC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220322000990 | UT | Part B Supplier - Ambulatory Surgical Center | 2466847843 | Practice locations: Vineyard, UT |
National Provider Directory
- Tax ID family
- Vineyard Surgery Center
Locations
691 E 400 N
Ste 100
Vineyard, UT 84059
Phone (385) 203-0246
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Yes |
Addresses
Primary practice location
691 E 400 N Ste 100
Vineyard, UT 84059-7509
Mailing address
PO Box 912042
St George, UT 84791-2042
Phone (435) 215-0228
Other providers in Vineyard, UT
- Vineyard Counseling, LLC
- Vineyard Eye Care LLC
- Vineyard Heights Dental LLC
- Vineyard Oral and Maxillofacial Surgery
- Vineyard Surgery Center, LLC
- Rebecca Ann Waite
- Connan Wallace
- Leticia Bench Wasden
- Bryan Weed
- Brett Wheatfill
All providers in Vineyard, UT · Ambulatory Surgical Clinic/Center in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 15, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.