SUMMIT SURGICAL SUITES, LLC
Surgery Yellow Pages
Fort Wayne, Indiana
Provider NPI: 1154322410
Organization Information:Organization Name: SUMMIT SURGICAL SUITES, LLC
Practice Location:
7920 W JEFFERSON BLVD SUITE 210 FORT WAYNE, IN 46804 US
Tel: 260-434-2022 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
7920 W JEFFERSON BLVD SUITE 210 FORT WAYNE, IN 46804 US
Tel: 260-434-2022 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 261QA1903X | Ambulatory Health Care Facilities Clinic/Center Ambulatory Surgical | IN | 05-003212-1 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
200413500 | IN | 05 | |
PHP PROVIDER NUMBER | 13443 | IN | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin