GRANGER SURGERY CENTER LLC NPI 1215675111

NPI Information

NPI: 1215675111
Provider Name: GRANGER SURGERY CENTER LLC

Former Legal Business Name: NORTHERN INDIANA SURGERY CENTER LLC

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
51050 BITTERSWEET RD STE A
GRANGER, IN
ZIP 46530
Phone: (718) 208-0446
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GRANGER SURGERY CENTER LLC is an ambulatory surgical clinic center in Granger, IN. GRANGER SURGERY CENTER LLC NPI is 1215675111. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Northern Indiana Surgery Center Llc.

The provider's business location address is:

51050 BITTERSWEET RD STE A
GRANGER, IN
ZIP 46530-879
Phone: (718) 208-0446
Fax: (574) 244-0240

The provider's authorized official is Kristina Music .
The authorized official title is Director Of Provider Enrollment and has the following contact phone number (615) 465-7377.

The CLIA number assigned to this NPI record is 15D2264013 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/22/2022 and was last updated on 1/9/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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