BLOOMINGTON ADVANCED SURGERY CENTER LLC NPI 1467128819

NPI Information

NPI: 1467128819
Provider Name: BLOOMINGTON ADVANCED SURGERY CENTER, LLC

Doing Business As: BLOOMINGTON ADVANCED SURGERY CENTER

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
445 S LANDMARK AVE
BLOOMINGTON, IN
ZIP 47403
Phone: (708) 275-7799
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BLOOMINGTON ADVANCED SURGERY CENTER, LLC is an ambulatory surgical clinic center in Bloomington, IN. BLOOMINGTON ADVANCED SURGERY CENTER, LLC NPI is 1467128819. The provider is registered as an organization entity type.
The provider Is Doing Business As Bloomington Advanced Surgery Center.

The provider's business location address is:

445 S LANDMARK AVE
BLOOMINGTON, IN
ZIP 47403-004
Phone: (708) 275-7799

The provider's authorized official is Wesley G Lackey .
The authorized official title is Medical Director and has the following contact phone number (317) 455-1064.

The enumeration date for this NPI number is 8/17/2021 and was last updated on 8/17/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. 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			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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