Organization
MOORESVILLE ENDOSCOPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD HOOPINGARNER (VICE PRESIDENT CEO)
(317) 781-3604
Entity
Organization
Contact information
Practice address
1215 HADLEY RD, STE 101, MOORESVILLE, IN 46158-2905
(317) 834-5800
Mailing address
5224 S EAST ST, SUITE C-9, INDIANAPOLIS, IN 46227-1990
(317) 781-3604
(317) 780-3121
Taxonomy
Speciality
Code
Description
License number
State
261QE0800X
Endoscopy Clinic/Center
Primary
040041001
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15C0001165
CCN
—
05
—
200505280A
—
IN
01
—
ZJ7020
MEDICARE
—
Enumeration date
05/03/2006
Last updated
06/30/2016
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