Provider Demographics
NPI:1215187802
Name:FISHERS AMBULATORY SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:FISHERS AMBULATORY SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:T
Authorized Official - Last Name:TROBRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:765-741-2957
Mailing Address - Street 1:13914 STATE ROAD 238 EAST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-7211
Mailing Address - Country:US
Mailing Address - Phone:317-415-9180
Mailing Address - Fax:317-415-9068
Practice Address - Street 1:13914 STATE ROAD 238 EAST
Practice Address - Street 2:SUITE 200
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-5506
Practice Address - Country:US
Practice Address - Phone:317-415-9180
Practice Address - Fax:317-415-9068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-19
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical