NEWTON ROCKDALE AMBULATORY SURGERY CENTER NPI 1396735833

NPI Information

NPI: 1396735833
Provider Name: NEWTON ROCKDALE AMBULATORY SURGERY CENTER

Other Name: PULLIAM AMBULATORY SURGERY CENTER

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
4167 HOSPITAL DR NE
COVINGTON, GA
ZIP 30014
Phone: (770) 786-1234
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NEWTON ROCKDALE AMBULATORY SURGERY CENTER is an ambulatory surgical clinic center in Covington, GA. NEWTON ROCKDALE AMBULATORY SURGERY CENTER NPI is 1396735833. The provider is registered as an organization entity type.
The provider Other Name Is Pulliam Ambulatory Surgery Center.

The provider's business location address is:

4167 HOSPITAL DR NE
COVINGTON, GA
ZIP 30014-565
Phone: (770) 786-1234
Fax: (770) 385-0813

The provider's authorized official is Morris Michael Pulliam .
The authorized official title is Medical Director and has the following contact phone number (770) 786-1234.

The enumeration date for this NPI number is 10/26/2005 and was last updated on 10/10/2011.

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	122-036	GEORGIA	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	51001066001	OTHER	GEORGIA	BLUE CROSS BLUE SHIELD
2	490002755	OTHER	GEORGIA	RRR MEDICARE #
3	=========	OTHER	GEORGIA	ALL OTHER CARRIERS
4	000420802A	MEDICAID	GEORGIA
5	111019	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

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