SULLIVAN SURGICENTER,LLC (NPI# 1700854072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700854072 |
| Entity Type | Organization |
| Organization Name | SULLIVAN SURGICENTER,LLC |
| Practice Address |
320 N Section St Sullivan IN 47882-1239 |
| Practice Telephone | 8122689000 |
| Practice Fax Number | 8122688822 |
| Mailing Telephone | 8122689000 |
| Mailing Fax Number | 8122688822 |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2012-12-06 |
| Authorized Official Name | DR. CUSTODIO L LIM (CEO) |
| Authorized Official Telephone | 8122689000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
05-003633-1 | IN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200503030 | 05 |
| Street Address |
320 N SECTION ST |
| City | SULLIVAN |
| State | IN |
| Zip Code | 47882-1239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659718336 | Neil Lynn Smith | Dentist | 118 S. Court St., Sullivan, IN 47882 | 2013-06-04 |
| 1184888000 | Mary Sherman Hospital | Hospice Care, Community Based | 817 North Section Street, Suite A, Sullivan, IN 47882 | 2008-07-10 |
| 1003838194 | Johnson Memorial Hospital | Durable Medical Equipment & Medical Supplies | 505 West Wolfe Street, Sullivan, IN 47882 | 2006-07-24 |
| 1255580593 | Daniel Choyce Callahan | Psychiatry & Neurology | 2204 N Section St, Sullivan, IN 47882 | 2008-09-11 |
| 1851394175 | Van Evanoff Jr. | Pain Medicine | 2204 N Section St, Suite B, Sullivan, IN 47882-0010 | 2005-05-31 |
| 1982780748 | Associated Physicians & Surgeons Clinic, LLC | Obstetrics & Gynecology | 2204 N Section St, Suite B, Sullivan, IN 47882-0010 | 2006-10-27 |
| 1871996199 | Sullivan Family Dentistry, LLC | Dentist | 2186 N Hospital Blvd., Suite 1, Sullivan, IN 47882-0468 | 2014-10-01 |
| 1487828455 | Kortni Reann Martindale | Speech-Language Pathologist | 368 W Indiana Ave, Sullivan, IN 47882-1117 | 2008-04-21 |
| 1831280585 | Southwest School Corporation | Local Education Agency (LEA) | 110 N Main St, Sullivan, IN 47882-1225 | 2006-09-27 |
| 1780717637 | Brian K Grindstaff | Chiropractor | 210 N Section St Unit C, Sullivan, IN 47882-1237 | 2007-03-13 |
| Find all providers in zip 47882 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457960536 | Lake George Surgery Center, LLC | Clinic/Center | 6245 N Old 27 Ste A10, Fremont, IN 46737-8707 | 2020-07-24 |
| 1689282741 | Uaa Indae LLC | Clinic/Center | 4715 Statesmen Dr Ste A, Indianapolis, IN 46250-1997 | 2020-07-15 |
| 1154959179 | Munster Surgery Center LLC | Clinic/Center | 1950 45thstreet, Unit 101, Munster, IN 46321 | 2020-03-27 |
| 1538791272 | Parkview Health System, Inc. | Clinic/Center | 8004 Carnegie Blvd, Fort Wayne, IN 46804-5785 | 2020-02-11 |
| 1174165237 | River Ridge Surgical Suites, LLC | Clinic/Center | 2031 Jeffersonville Commons Dr, Jeffersonville, IN 47130-8996 | 2019-10-10 |
| 1134779622 | Helix Surgicenter LLC | Clinic/Center | 324 W Us Highway 30, Schererville, IN 46375-1856 | 2019-09-17 |
| 1295381572 | South Suburban Surgical Suites, LLC | Clinic/Center | 9200 Calumet Ave Ste E-100, Munster, IN 46321-2885 | 2019-08-13 |
| 1861059818 | Fishers Specialty Surgery Center, LLC | Clinic/Center | 14300 E 138th St, Fishers, IN 46037 | 2019-05-24 |
| 1154887040 | Jesc LLC | Clinic/Center | 647 West Second Street Suite A, Jasper, IN 47546 | 2019-02-15 |
| 1609376409 | Kokomo Ambulatory Surgery Center | Clinic/Center | 107 S Washington St Ste A, Kokomo, IN 46901-4601 | 2018-02-19 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.