Provider Demographics
NPI: | 1427641042 |
---|---|
Name: | ALLISONVILLE OUTPATIENT SURGERY CENTER, LLC |
Entity type: | Organization |
Organization Name: | ALLISONVILLE OUTPATIENT SURGERY CENTER, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | BUSINESS OFFICE MANAGER |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | RACHELLE |
Authorized Official - Middle Name: | LYNN |
Authorized Official - Last Name: | KILLION |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 317-569-0033 |
Mailing Address - Street 1: | 10967 ALLISONVILLE RD STE 100 |
Mailing Address - Street 2: | |
Mailing Address - City: | FISHERS |
Mailing Address - State: | IN |
Mailing Address - Zip Code: | 46038-2634 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 317-569-0033 |
Mailing Address - Fax: | 317-569-0540 |
Practice Address - Street 1: | 10967 ALLISONVILLE ROAD |
Practice Address - Street 2: | |
Practice Address - City: | FISHERS |
Practice Address - State: | IN |
Practice Address - Zip Code: | 46038-2632 |
Practice Address - Country: | US |
Practice Address - Phone: | 317-569-0033 |
Practice Address - Fax: | 317-569-0540 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2021-02-15 |
Last Update Date: | 2025-03-06 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QA1903X | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |