BLOOMINGTON ENDOSCOPY CENTER LLC NPI 1689679508

NPI Information

NPI: 1689679508
Provider Name: BLOOMINGTON ENDOSCOPY CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
550 S LANDMARK AVE
BLOOMINGTON, IN
ZIP 47403
Phone: (812) 331-3650
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BLOOMINGTON ENDOSCOPY CENTER, LLC is an ambulatory surgical clinic center in Bloomington, IN. BLOOMINGTON ENDOSCOPY CENTER, LLC NPI is 1689679508. The provider is registered as an organization entity type.

The provider's business location address is:

550 S LANDMARK AVE
BLOOMINGTON, IN
ZIP 47403-239
Phone: (812) 331-3650
Fax: (812) 355-6925

The provider's authorized official is Michael Craig .
The authorized official title is Cfo and has the following contact phone number (812) 353-9554.

The enumeration date for this NPI number is 6/16/2005 and was last updated on 12/7/2018.

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	05-002674-1	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	200319120	MEDICAID	INDIANA

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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