| Organization Name: | GOSHEN AMBULATORY CARE CENTER LLC |
| NPI Number: | 1043288111 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DEBORAH STARNES (OFFICE ADMINISTRATOR) |
| Mailing Address: | 1605 Winsted Dr Goshen |
| State: | IN US |
| Postal Code: | 465264655 |
| Phone Number: | 5745348794 |
| Fax Number: | 5745343082 |
| NPI Enumeration Date: | 03/14/2006 |
| NPI Last Update Date: | 06/11/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |