# SAGAMORE SURGICAL SERVICES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003816307
- **Authorized official:** SHELBY ATKINSON BROUILLETTE RN (ADMINISTRATOR DON)
- **Authorized official phone:** (765) 474-7838

## Contact information

- **Practice address:** 2320 CONCORD RD, STE B, LAFAYETTE, IN 47909-2708
- **Practice address phone:** (765) 474-7854
- **Mailing address:** PO BOX 112, MUNCIE, IN 47308-0112
- **Mailing address phone:** (765) 284-0493
- **Mailing address fax:** (765) 284-2434

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 05-006126-1 | IN | Yes |

## Other

- **Enumeration date:** 07/28/2005
- **Last updated:** 04/22/2025