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1427373679 NPI number — INDIANA UNIVERSITY HEALTH LAKESHORE SURGICARE LLC

NPI Number: 1427373679
Health Care Provider/Practitioner: INDIANA UNIVERSITY HEALTH LAKESHORE SURGICARE LLC

Information about “1427373679” NPI (INDIANA UNIVERSITY HEALTH LAKESHORE SURGICARE LLC) exists in 1427373679 in HTML format HTML  |  1427373679 in plain Text format TXT  |  1427373679 in PDF (Portable Document Format) PDF  |  1427373679 in an XML format XML  formats.

NPI Number : 1427373679 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1427373679",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "INDIANA UNIVERSITY HEALTH LAKESHORE SURGICARE LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3111 VILLAGE POINTE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CHESTERTON",
    "MailingAddressStateName": "IN",
    "MailingAddressPostalCode": "46304-9689",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "219-983-1401",
    "MailingAddressFaxNumber": "219-929-1408",
    "FirstLinePracticeLocationAddress": "3111 VILLAGE POINTE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CHESTERTON",
    "PracticeLocationAddressStateName": "IN",
    "PracticeLocationAddressPostalCode": "46304-9689",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "219-983-1401",
    "PracticeLocationAddressFaxNumber": "219-929-1408",
    "EnumerationDate": "03/31/2010",
    "LastUpdateDate": "08/07/2013",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "THORDARSON",
    "AuthorizedOfficialFirstName": "GUDSTEINN",
    "AuthorizedOfficialMiddleName": "T",
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "N/A",
    "AuthorizedOfficialTelephoneNumber": "219-326-2555",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261QA1903X",
          "TaxonomyName": "Ambulatory Surgical Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QA1903X",
          "TaxonomyName": "Ambulatory Surgical Clinic/Center",
          "LicenseNumber": "13-011186-1",
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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