Provider Demographics
NPI:1518197011
Name:UNITED SURGEONS, LLC
Entity Type:Organization
Organization Name:UNITED SURGEONS, LLC
Other - Org Name:UNITY PHYSICIANS HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-231-6800
Mailing Address - Street 1:3930 EDISON LAKES PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-3418
Mailing Address - Country:US
Mailing Address - Phone:574-231-6800
Mailing Address - Fax:574-231-6845
Practice Address - Street 1:4455 EDISON LAKES PKWY
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-1442
Practice Address - Country:US
Practice Address - Phone:574-231-6800
Practice Address - Fax:574-231-6845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-17
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200968790 AMedicaid
IN150177Medicare Oscar/Certification