Organization Name: | CENTER FOR SPECIALTY SURGERY |
NPI Number: | 1073564605 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN BARNEY (PRESIDENT) |
Mailing Address: | 1950 45th Ave Munster |
State: | IN US |
Postal Code: | 463213917 |
Phone Number: | 2199225100 |
Fax Number: | 2199341052 |
NPI Enumeration Date: | 05/16/2006 |
NPI Last Update Date: | 07/25/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA1903X |
License Number: | 06-004600-2 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Ambulatory Surgical |
Taxonomy Definition: |