CENTER FOR SPINE INTERVENTIONS ASC 1 LLC NPI 1801228481

NPI Information

NPI: 1801228481
Provider Name: CENTER FOR SPINE INTERVENTIONS ASC 1 LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 11D2049696

Address:
4586 TIMBER RIDGE DR STE 141
DOUGLASVILLE, GA
ZIP 30135
Phone: (678) 813-2741
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CENTER FOR SPINE INTERVENTIONS ASC 1 LLC is an ambulatory surgical clinic center in Douglasville, GA. CENTER FOR SPINE INTERVENTIONS ASC 1 LLC NPI is 1801228481. The provider is registered as an organization entity type.

The provider's business location address is:

4586 TIMBER RIDGE DR STE 141
DOUGLASVILLE, GA
ZIP 30135-517
Phone: (678) 813-2741
Fax: (770) 575-3912

The provider's authorized official is Janice Raya .
The authorized official title is Office Manager and has the following contact phone number (678) 813-2741.

The CLIA number assigned to this NPI record is 11D2049696 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/6/2013 and was last updated on 7/22/2021.

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

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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