ENDOSCOPY CENTER OF MIDDLE GEORGIA LLC NPI 1215915939

NPI Information

NPI: 1215915939
Provider Name: ENDOSCOPY CENTER OF MIDDLE GEORGIA LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 11D1027514

Address:
610 THIRD STREET
MACON, GA
ZIP 31201
Phone: (478) 464-2600
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ENDOSCOPY CENTER OF MIDDLE GEORGIA LLC is an ambulatory surgical clinic center in Macon, GA. ENDOSCOPY CENTER OF MIDDLE GEORGIA LLC NPI is 1215915939. The provider is registered as an organization entity type.

The provider's business location address is:

610 THIRD STREET
MACON, GA
ZIP 31201
Phone: (478) 464-2600
Fax: (478) 738-9740

The provider's authorized official is Sarah Gibbert .
The authorized official title is Administrator and has the following contact phone number (478) 464-2600.

The CLIA number assigned to this NPI record is 11D1027514 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/3/2006 and was last updated on 8/7/2014.

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	011294	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	111245ASCA	MEDICARE PIN	GEORGIA
2	720442190A	MEDICAID	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: 4/28/2024

NPI Synchronization or Removal

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