AUGUSTA RETINA LASER SURGICARE NPI 1235118043

NPI Information

NPI: 1235118043
Provider Name: AUGUSTA RETINA LASER SURGICARE
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 11D0960343

Address:
3685 WHEELER RD
SUITE 202
AUGUSTA, GA
ZIP 30909
Phone: (706) 210-0305
Get Directions

AUGUSTA RETINA LASER SURGICARE is an ambulatory surgical clinic center in Augusta, GA. AUGUSTA RETINA LASER SURGICARE NPI is 1235118043. The provider is registered as an organization entity type.

The provider's business location address is:

3685 WHEELER RD
SUITE 202
AUGUSTA, GA
ZIP 30909-446
Phone: (706) 210-0305
Fax: (706) 210-0306

The provider's authorized official is Harinderjit Singh .
The authorized official title is President and has the following contact phone number (706) 210-0305.

The CLIA number assigned to this NPI record is 11D0960343 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/10/2006 and was last updated on 9/16/2016.

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		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
1	000874794A	MEDICAID	GEORGIA
2	ASC025	MEDICAID	SOUTH CAROLINA
3	490004637	MEDICARE PIN	GEORGIA
4	111167ASCA	MEDICARE ID-TYPE UNSPECIFIED	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

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