Organization Name: | NORTHERN INDIANA AMBULATORY SURGERY |
NPI Number: | 1033190566 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CLARA M TAYLOR (BUSINESS MANAGER) |
Mailing Address: | 500 Arcade Ave Suite 100 Elkhart |
State: | IN US |
Postal Code: | 465142477 |
Phone Number: | 5745229505 |
Fax Number: | 5742966484 |
NPI Enumeration Date: | 11/10/2005 |
NPI Last Update Date: | 04/10/2015 |
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: |