Organization
AMEDCO INDIANA LLC
Active
Other names
Wabash Valley Eye Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA PERREIRA (COO)
(877) 881-0022
Entity
Organization
Contact information
Practice address
2020 S CLEARVIEW DR, VINCENNES, IN 47591-5576
(812) 882-9600
(812) 882-2944
Mailing address
2020 S CLEARVIEW DR, P.O. BOX 924, VINCENNES, IN 47591-5576
(812) 882-9600
(812) 882-2944
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
070028971
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200363570A
—
IN
Enumeration date
01/22/2007
Last updated
10/23/2013
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