Organization
BLOOMINGTON ASC, LLC
Active
Other names
Indiana Specialty Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
PETER BLACH (OFFICER/AUTHORIZED OFFICIAL)
(713) 343-0832
Entity
Organization
Contact information
Practice address
1380 W ARCH HAVEN AVE, BLOOMINGTON, IN 47403-2055
(812) 330-1164
(812) 332-5102
Mailing address
1380 W ARCH HAVEN AVE, BLOOMINGTON, IN 47403-2055
(812) 330-1164
(812) 332-5102
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
14-011996-1
IN
Other
Enumeration date
01/24/2014
Last updated
10/04/2024
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