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General NPI Number Information
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NPI Number | 1043204688
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Entity Type | Organization
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Legal Business Name | INDIANA AMBULATORY SURGICAL ASSOCIATES, INC
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Dates
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Enumeration Date | 09/09/2005
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 841 HOSPITAL RD STE 1200
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City | INDIANA
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State | PA
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Zip | 15701-3660
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Country | US
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Telephone | 724-465-1922
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Fax | 724-465-2636
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Provider Business Mailing Address
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Address Line | 841 HOSPITAL RD STE 1200
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City | INDIANA
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State | PA
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Zip | 15701-3660
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Country | US
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Telephone | 724-465-1922
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Fax | 724-465-2636
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JEREMY BURTON SMITH
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Credential | MHA
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Telephone | 724-465-1922
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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 | 10561500
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License Number State | PA
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