Provider Demographics
NPI:1477846145
Name:INDIANA UNIVERSITY HEALTH SAXONY SURGERY CENTER LLC
Entity Type:Organization
Organization Name:INDIANA UNIVERSITY HEALTH SAXONY SURGERY CENTER LLC
Other - Org Name:SAXONY SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER - AMBULATORY OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAEFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-817-1450
Mailing Address - Street 1:10300 N ILLINOIS ST STE 2055
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46290-1167
Mailing Address - Country:US
Mailing Address - Phone:317-817-1450
Mailing Address - Fax:317-805-2243
Practice Address - Street 1:13100 EAST 136TH STREET
Practice Address - Street 2:1100
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037
Practice Address - Country:US
Practice Address - Phone:317-817-1450
Practice Address - Fax:317-805-2243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-27
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201075520AMedicaid
INM300075656OtherMEDICARE PTAN