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General NPI Number Information
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NPI Number | 1003897448
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Entity Type | Organization
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Legal Business Name | NORTHWEST SURGERY CENTER LLC
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Dates
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Enumeration Date | 11/11/2005
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Last Update Date | 01/23/2015
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Provider Practice Location Address
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Address Line | 8651 TOWNSHIP LINE ROAD
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-1578
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Country | US
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Telephone | 317-621-3010
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Fax | 317-621-3011
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Provider Business Mailing Address
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Address Line | 8651 TOWNSHIP LINE RD
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-1578
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Country | US
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Telephone | 317-621-3010
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Fax | 317-621-3011
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Authorized Official
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Title or Position | DIRECTOR OF BUSINESS OPERATIONS
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Name | MELISSA HUGHES
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Credential |
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Telephone | 317-621-7509
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 61100198B
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License Number State | IN
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