Organization
CENTRAL INDIANA ORTHOPEDIC SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VICTOR P MORAN (EXECUTIVE DIRECTOR/CFO)
(765) 284-7738
Entity
Organization
Contact information
Practice address
3600 W BETHEL AVE, MUNCIE, IN 47304-5407
(765) 284-7738
(765) 213-3713
Mailing address
PO BOX 1987, MUNCIE, IN 47308-1987
(765) 284-7738
(765) 213-3713
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000098210
ANTHEM PIN
IN
05
—
200220380
—
IN
Enumeration date
08/09/2006
Last updated
04/17/2015
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