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Contact Information

CCSG LLC
1801 N SENATE BLVD
STE 755
INDIANAPOLIS, IN46202-1228
 Phone: 317-962-5888
 Fax: 317-962-6259
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Thoracic Surgery (Cardiothoracic Vascular Surgery)

208G00000X 02 Physician/General Surgery
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for CCSG LLC

NPI # 1700057718
LBN Legal business name CCSG LLC
Authorized official SAMUEL ODLE - (PRESIDENT/CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 03/18/2008
Last updated 02/16/2010 - About 16 years ago
Identifiers
IN Medicaid 200906830
IN Other DN6820 RAILROAD MEDICARE GROUP
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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