NPI:
1215069166
Provider Name:
ATLAS SURGERY CENTER OF BUCKHEAD, INC
Former Legal Business Name: RODERIQUE SURGI-CENTER, INC.
Classification:
Clinic/Center - 261QA1903X
Entity Type:
Organization
Specialization: Ambulatory Surgical
CLIA Number: 11D1059248
Address:
2045 PEACHTREE RD NE STE T1
ATLANTA, GA
ZIP 30309
Phone:
(786) 701-2225
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ATLAS SURGERY CENTER OF BUCKHEAD, INC is an ambulatory surgical clinic center in Atlanta, GA. ATLAS SURGERY CENTER OF BUCKHEAD, INC NPI is 1215069166. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Roderique Surgi-center, Inc..
The provider's business location address is:
2045 PEACHTREE RD NE STE T1
ATLANTA, GA
ZIP 30309-405
Phone: (786) 701-2225
Fax: (678) 412-1672
The provider's authorized official is Michael Basille .
The authorized official title is Owner and has the following contact phone number (678) 701-2225.
The CLIA number assigned to this NPI record is 11D1059248 - ambulatory surgery center with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 3/9/2007 and was last updated on 4/1/2021.