BELTWAY SURGERY CENTERS LLC (INDIANA HAND TO SHOULDER BELTWAY SURGERY CENTER) - NPI NUMBER 1205939345

Summary

Provider Name: BELTWAY SURGERY CENTERS LLC (INDIANA HAND TO SHOULDER BELTWAY SURGERY CENTER)

NPI Number: 1205939345

Clasification: Clinic/Center (261QA1903X)

Specialization: Ambulatory Surgical

Address:
8501 HARCOURT RD
INDIANAPOLIS, IN
ZIP 46260

Phone Number: (317) 875-9105



Detailed Information

BELTWAY SURGERY CENTERS LLC is an ambulatory surgical clinic/center in Indianapolis, IN. The assigned NPI number for this provider is 1205939345 and is registered as an organization entity type.
The provider Is Doing Business As Indiana Hand To Shoulder Beltway Surgery Center.

The provider's business address is:

8501 HARCOURT RD
INDIANAPOLIS, IN
ZIP 46260-046
Phone: (317) 875-9105
Fax: (317) 875-8638

The provider's authorized official is Robert Boeglin .
The authorized official title is President and has the following contact phone number (317) 817-1456.

The enumeration date for this NPI number is 9/6/2006 and was last updated on 7/22/2013.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 261QA1903X Clinic/Center Ambulatory Surgical 13-005400-1 IN Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 000000097860 OTHER IN ANTHEM
2 201137250A MEDICAID IN
3 IN1237 MEDICARE OSCAR/CERTIFICATION IN

NPI Record

No. Field Name Field Value
1 NPI 1205939345
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name BELTWAY SURGERY CENTERS LLC
5 Provider Other Organization Name INDIANA HAND TO SHOULDER BELTWAY SURGERY CENTER
6 Provider Other Organization Name Type Code 3
7 Provider First Line Business Practice Location Address 8501 HARCOURT RD
8 Provider Business Practice Location Address City Name INDIANAPOLIS
9 Provider Business Practice Location Address State Name IN
10 Provider Business Practice Location Address Postal Code 462602046
11 Provider Business Practice Location Address Country Code If outside U S US
12 Provider Business Practice Location Address Telephone Number 3178759105
13 Provider Business Practice Location Address Fax Number 3178758638
14 Provider Enumeration Date 9/6/2006
15 Last Update Date 7/22/2013
16 Authorized Official Last Name BOEGLIN
17 Authorized Official First Name ROBERT
18 Authorized Official Title or Position PRESIDENT
19 Authorized Official Telephone Number 3178171456
20 Healthcare Provider Taxonomy Code 1 261QA1903X
21 Provider License Number 1 13-005400-1
22 Provider License Number State Code 1 IN
23 Healthcare Provider Primary Taxonomy Switch 1 Y
24 Other Provider Identifier 1 000000097860
25 Other Provider Identifier Type Code 1 01
26 Other Provider Identifier State 1 IN
27 Other Provider Identifier Issuer 1 ANTHEM
28 Other Provider Identifier 2 201137250A
29 Other Provider Identifier Type Code 2 05
30 Other Provider Identifier State 2 IN
31 Other Provider Identifier 3 IN1237
32 Other Provider Identifier Type Code 3 06
33 Other Provider Identifier State 3 IN
34 Is Organization Subpart Y
35 Parent Organization LBN HAND SURGERY ASSOCIATES OF INDIANA INC
36 Parent Organization TIN
37 Authorized Official Name Prefix Text MR.
38 Authorized Official Credential Text MD

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This page was last updated on: 9/11/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.