MEDICARE: NORTH MERIDIAN SURGICENTER & ASSOCIATES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center	10007125-1	IN

General Provider Information

NPI Number	:	1104125111
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH MERIDIAN SURGICENTER & ASSOCIATES, LLC

Provider Business Mailing Address
First Line	:	PO BOX 68952
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-0952
Country	:	US
Telephone Number	:	317-802-3135
Fax Number	:	317-870-0499

Provider Business Practice Location Address
First Line	:	10601 N MERIDIAN ST
Second Line	:	STE 100
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46290-1152
Country	:	US
Telephone Number	:	317-574-5400
Fax Number	:	317-870-0499

Authorized Official
Title or Position	:	CEO
Name	:	JULIE BERZINS
Credential	:
Telephone Number	:	317-574-5400

Provider Enumeration Date	:	03/17/2011
Last Update Date	:	03/17/2011

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