STATESBORO AMBULATORY SURGERY CENTER INC NPI 1356619613

NPI Information

NPI: 1356619613
Provider Name: STATESBORO AMBULATORY SURGERY CENTER, INC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
95 BEL AIR DRIVE
STATESBORO, GA
ZIP 30461
Phone: (912) 489-6519
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STATESBORO AMBULATORY SURGERY CENTER, INC is an ambulatory surgical clinic center in Statesboro, GA. STATESBORO AMBULATORY SURGERY CENTER, INC NPI is 1356619613. The provider is registered as an organization entity type.

The provider's business location address is:

95 BEL AIR DRIVE
STATESBORO, GA
ZIP 30461
Phone: (912) 489-6519
Fax: (912) 764-7882

The provider's authorized official is Robert W Cushner .
The authorized official title is Ceo/owner and has the following contact phone number (912) 489-8727.

The enumeration date for this NPI number is 12/1/2011 and was last updated on 12/1/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000624896A	MEDICAID	GEORGIA
2	GRP4317	OTHER		PROVIDER TRANSACTION ACCESS NUMBER
3	111060ASCA	MEDICARE PIN	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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