Provider Demographics
NPI:1649292004
Name:NOVAMED EYE SURGERY CENTER OF NEW ALBANY, LLC
Entity type:Organization
Organization Name:NOVAMED EYE SURGERY CENTER OF NEW ALBANY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VP AND CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:T
Authorized Official - Last Name:MACOMBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-780-3234
Mailing Address - Street 1:1700 E HIGGINS RD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60018-5621
Mailing Address - Country:US
Mailing Address - Phone:847-296-5700
Mailing Address - Fax:847-296-5990
Practice Address - Street 1:1305 WALL ST
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3853
Practice Address - Country:US
Practice Address - Phone:812-288-9674
Practice Address - Fax:812-283-6955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical