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General NPI Number Information
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NPI Number | 1497782833
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Entity Type | Organization
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Legal Business Name | CARMEL AMBULATORY SURGERY CENTER LLC
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 12/10/2013
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Provider Practice Location Address
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Address Line | 13421 OLD MERIDIAN ST SUITE 100
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City | CARMEL
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State | IN
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Zip | 46032-1427
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Country | US
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Telephone | 317-706-1600
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Fax | 317-706-1601
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Provider Business Mailing Address
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Address Line | 13421 OLD MERIDIAN ST SUITE 100
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City | CARMEL
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State | IN
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Zip | 46032-1427
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Country | US
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Telephone | 317-706-1600
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Fax | 317-706-1601
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Authorized Official
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Title or Position | DIRECTOR
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Name | MISS CHARLOTTE BODEN
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Credential |
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Telephone | 317-706-1611
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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 | 06-003497-1
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License Number State | IN
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