CENTER FOR SOUTHSIDE SURGERY LLC NPI 1003292483

NPI Information

NPI: 1003292483
Provider Name: CENTER FOR SOUTHSIDE SURGERY, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 15D0992533

Address:
533 E COUNTY LINE RD
SUITE 201
GREENWOOD, IN
ZIP 46143
Phone: (317) 706-7246
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CENTER FOR SOUTHSIDE SURGERY, LLC is an ambulatory surgical clinic center in Greenwood, IN. CENTER FOR SOUTHSIDE SURGERY, LLC NPI is 1003292483. The provider is registered as an organization entity type.

The provider's business location address is:

533 E COUNTY LINE RD
SUITE 201
GREENWOOD, IN
ZIP 46143-073
Phone: (317) 706-7246
Fax: (317) 706-3419

The provider's authorized official is Christina Mandabach .
The authorized official title is Director Of Business Ops and has the following contact phone number (317) 706-7246.

The CLIA number assigned to this NPI record is 15D0992533 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/7/2015 and was last updated on 4/11/2023.

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		INDIANA	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

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