Provider Demographics
NPI:1003535717
Name:SURGERY CENTERS OF NW INDIANA LLC
Entity Type:Organization
Organization Name:SURGERY CENTERS OF NW INDIANA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:317-385-3051
Mailing Address - Street 1:5735 SEA TURTLE PL
Mailing Address - Street 2:
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572-3351
Mailing Address - Country:US
Mailing Address - Phone:317-385-3051
Mailing Address - Fax:
Practice Address - Street 1:415 SPRINGWOOD DR
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-7935
Practice Address - Country:US
Practice Address - Phone:317-385-3051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical