Provider Demographics
NPI:1609052679
Name:BELTWAY SURGERY CENTERS, LLC
Entity Type:Organization
Organization Name:BELTWAY SURGERY CENTERS, LLC
Other - Org Name:BELTWAY SURGERY CENTER SPRINGMILL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
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
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46290-1166
Mailing Address - Country:US
Mailing Address - Phone:317-278-5050
Mailing Address - Fax:
Practice Address - Street 1:10300 N ILLINOIS ST
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46290-1166
Practice Address - Country:US
Practice Address - Phone:317-278-5050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN080022771261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZJ9010OtherMEDICARE PTAN
IN200891870AMedicaid