Provider Demographics
NPI:1386721249
Name:ALLIED PHYSICIANS SURGERY CENTER, LLC
Entity type:Organization
Organization Name:ALLIED PHYSICIANS SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:THOMASINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:574-247-3322
Mailing Address - Street 1:53990 CARMICHAEL DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46635-1582
Mailing Address - Country:US
Mailing Address - Phone:574-243-9700
Mailing Address - Fax:574-247-3300
Practice Address - Street 1:53990 CARMICHAEL DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46635-1582
Practice Address - Country:US
Practice Address - Phone:574-243-9700
Practice Address - Fax:574-247-3300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06-010984-1261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical