Provider Demographics
NPI:1326286360
Name:NORTH CAMPUS SURGERY CENTER LLC
Entity Type:Organization
Organization Name:NORTH CAMPUS SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:ARRENDALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-621-2000
Mailing Address - Street 1:8040 CLEARVISTA PKWY STE 150
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-4673
Mailing Address - Country:US
Mailing Address - Phone:317-621-2000
Mailing Address - Fax:
Practice Address - Street 1:8040 CLEARVISTA PKWY STE 150
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-4673
Practice Address - Country:US
Practice Address - Phone:317-621-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-29
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN080059731261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN15C0001033Medicare PIN