# VISIONARY SURGERY CENTER, LLC

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

## Provider details

- **NPI number:** 1821810326
- **Authorized official:** ERIN MALLOY (ADMINISTRATOR)
- **Authorized official phone:** (417) 447-4484

## Contact information

- **Practice address:** VISIONARY SURGERY CENTER, LLC, 4335 EDISON LAKES PKWY, MISHAWAKA, IN 46545
- **Practice address phone:** (417) 447-4484
- **Mailing address:** VISIONARY SURGERY CENTER, LLC, 4335 EDISON LAKES PKWY, MISHAWAKA, IN 46545

## Taxonomy

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

## Other

- **Enumeration date:** 10/28/2024
- **Last updated:** 10/28/2024