Provider Demographics
NPI:1740482751
Name:MERRIVILLE PLAZA SURGERY CENTER
Entity type:Organization
Organization Name:MERRIVILLE PLAZA SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAYAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-791-0500
Mailing Address - Street 1:255 E 90TH DR
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE BRA
Mailing Address - State:IN
Mailing Address - Zip Code:46410-8103
Mailing Address - Country:US
Mailing Address - Phone:219-791-0500
Mailing Address - Fax:
Practice Address - Street 1:255 E 90TH DR
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE BRA
Practice Address - State:IN
Practice Address - Zip Code:46410-8103
Practice Address - Country:US
Practice Address - Phone:219-791-0500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical