Provider Demographics
NPI:1780331769
Name:ASC SURGICAL VENTURES, LLC
Entity type:Organization
Organization Name:ASC SURGICAL VENTURES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, OUTPATIENT SURGERY CENTER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:KRISHER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:574-266-4173
Mailing Address - Street 1:2310 CALIFORNIA RD
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46514-1228
Mailing Address - Country:US
Mailing Address - Phone:574-264-0791
Mailing Address - Fax:
Practice Address - Street 1:3028 BEACON PARKWAY
Practice Address - Street 2:
Practice Address - City:GRANGER
Practice Address - State:IN
Practice Address - Zip Code:46530
Practice Address - Country:US
Practice Address - Phone:574-266-4173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASC SURGICAL VENTURES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-09
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical