# UNITED SURGEONS, LLC

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

## Provider details

- **NPI number:** 1225441975
- **Authorized official:** DR. ALLISON TUCKER PHARMD, BCPS (DIRECTOR OF PHARMACY)
- **Authorized official phone:** (574) 339-8969

## Contact information

- **Practice address:** 4455 EDISON LAKES PKWY, MISHAWAKA, IN 46545-1442
- **Practice address phone:** (574) 231-6199
- **Mailing address:** 4455 EDISON LAKES PKWY, MISHAWAKA, IN 46545-1442

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336I0012X | Institutional Pharmacy | 60006215A | IN | Yes |

## Other

- **Enumeration date:** 06/10/2014
- **Last updated:** 06/13/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 150177 | MEDICARE PTAN | IN |
| 05 | — | 200968790A | — | IN |