| Organization Name: | ASC SURGICAL VENTURES, LLC |
| NPI Number: | 1083715148 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARCY GROW DORMAN (DIRECTOR, OUTPATIENT SURGERY CENTER) |
| Mailing Address: | 2310 California Rd Elkhart |
| State: | IN US |
| Postal Code: | 465141228 |
| Phone Number: | 5742640791 |
| Fax Number: | 5749701374 |
| NPI Enumeration Date: | 09/25/2006 |
| NPI Last Update Date: | 12/17/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 009555 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |