RENAISSANCE SURGICAL CENTRE LLC NPI 1396743514

NPI Information

NPI: 1396743514
Provider Name: RENAISSANCE SURGICAL CENTRE, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 11D1023871

Address:
4030 RIVERSIDE PARK BLVD
MACON, GA
ZIP 31210
Phone: (478) 474-2200
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RENAISSANCE SURGICAL CENTRE, LLC is an ambulatory surgical clinic center in Macon, GA. RENAISSANCE SURGICAL CENTRE, LLC NPI is 1396743514. The provider is registered as an organization entity type.

The provider's business location address is:

4030 RIVERSIDE PARK BLVD
MACON, GA
ZIP 31210-365
Phone: (478) 474-2200
Fax: (478) 314-0740

The provider's authorized official is Roy Powell .
The authorized official title is Medical Director and has the following contact phone number (478) 474-2200.

The CLIA number assigned to this NPI record is 11D1023871 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/12/2005 and was last updated on 8/22/2020.

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: 4/28/2024

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