| Organization Name: | SAGAMORE SURGICAL SERVICES, INC. |
| NPI Number: | 1003816307 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CAROL A BLANAR (ADMINISTRATOR, DON) |
| Mailing Address: | 2320 Concord Rd Ste B Lafayette |
| State: | IN US |
| Postal Code: | 479092708 |
| Phone Number: | 7654747854 |
| Fax Number: | |
| NPI Enumeration Date: | 07/28/2005 |
| NPI Last Update Date: | 03/18/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |