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Organization
SOUTH BEND IN ENDOSCOPY ASC LLC
Active
Organization
SOUTH BEND IN ENDOSCOPY ASC LLC
Active
Other names
Michiana Endoscopy Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY SNODGRASS (PRESIDENT)
(615) 665-1283
Entity
Organization
Contact information
Practice address
53830 GENERATIONS DR, SOUTH BEND, IN 46635-1557
(574) 271-0893
(574) 271-4362
Mailing address
1A BURTON HILLS BLVD, ATTN: L&C, NASHVILLE, TN 37215-6103
(574) 271-0893
(574) 271-4362
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
17-009761-1
IN
261QE0800X
Endoscopy Clinic/Center
010076
IN
Other
Enumeration date
05/31/2005
Last updated
06/28/2022
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