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Organization

SURGI-CARE LLC

Active
Other names
SurgiCare LLC
Organization subpart
No

Provider details

NPI number
Authorized official
BRIAN JOHN LOGUE M.D. (PRESIDENT)
(812) 332-8765
Entity
Organization

Contact information

Practice address
2907 MCINTIRE DRIVE, SUITE C, BLOOMINGTON, IN 47403-4224
(812) 339-8000
(812) 339-2524
Mailing address
2907 MCINTIRE DRIVE, SUITE C, BLOOMINGTON, IN 47403-4224
(812) 339-8000
(812) 339-2524

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
13-009971-1
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200145120
IN
Enumeration date
10/01/2013
Last updated
10/01/2013
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