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Saint Charles Surgical Pavilion INC

Clinic/Center, Ambulatory Surgical in Jasper, IN. Organization (NPI-2).

NPI number1477513844
StatusActive
Last updated in NPPESJan 13, 2012

Details

NPI
1477513844
Entity type
Organization (NPI-2)
Legal business name
Saint Charles Surgical Pavilion INC
Organization subpart
No
Enumeration date
Mar 28, 2006
Last updated
Jan 13, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QA1903X Clinic/Center, Ambulatory Surgical060025231INYes

Practice location

1900 Saint Charles Street
Jasper, IN 47546-9145

Phone 812-634-1211 · Fax 812-634-9762

Mailing address

1900 Saint Charles Street
Jasper, IN 47546-9145

Phone 812-634-1211 · Fax 812-634-9762

Authorized official

Randall Gene Norris
Owner Ceo
8126341211

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