Provider Demographics
NPI:1750668190
Name:ELKHART DAY SURGERY, LLC
Entity Type:Organization
Organization Name:ELKHART DAY SURGERY, LLC
Other - Org Name:INSIGHT SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HAYLEY
Authorized Official - Middle Name:G
Authorized Official - Last Name:BOLING
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:574-293-3545
Mailing Address - Street 1:2746 OLD US HWY 20 W.
Mailing Address - Street 2:STE. C
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46514-1364
Mailing Address - Country:US
Mailing Address - Phone:574-293-8366
Mailing Address - Fax:574-970-0115
Practice Address - Street 1:2746 OLD US HWY 20 W.
Practice Address - Street 2:STE. C
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-1364
Practice Address - Country:US
Practice Address - Phone:574-293-8366
Practice Address - Fax:574-970-0115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-14
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical