Organization
EAGLE HIGHLANDS SURGERY CENTER LLC
Active
Other names
Eagle Highlands Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT BOEGLIN (VICE PRESIDENT, EHSC)
(317) 562-5660
Entity
Organization
Contact information
Practice address
6850 PARKDALE PL, INDIANAPOLIS, IN 46254-4670
(317) 329-7209
(317) 329-7293
Mailing address
6850 PARKDALE PL, INDIANAPOLIS, IN 46254-4670
(317) 329-7209
(317) 329-7293
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200848180A
—
IN
01
—
ZJ7070
MEDICARE PTAN
—
Enumeration date
05/30/2006
Last updated
01/03/2011
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