# INDIANA SKIN CANCER AMBULATORY SURGICAL CENTER LLC

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

## Provider details

- **NPI number:** 1093921298
- **Authorized official:** JOHN RAYMOND BERNAT MD (OWNER)
- **Authorized official phone:** (330) 965-8760

## Contact information

- **Practice address:** 701 EAST COUNTY LINE ROAD, STE 208, GREENWOOD, IN 46143
- **Practice address phone:** (317) 859-8970
- **Practice address fax:** (317) 859-8977
- **Mailing address:** 111 NEW HAMPSHIRE AVE STE 2, PORTSMOUTH, NH 03801-2864
- **Mailing address phone:** (330) 947-6021
- **Mailing address fax:** (330) 965-9325

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/15/2007
- **Last updated:** 07/16/2026