AVVSC LAWRENCEVILLE LLC NPI 1427435007

NPI Information

  • NPI: 1427435007
  • Provider Name: AVVSC LAWRENCEVILLE, LLC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • CLIA Number: 11D2108805
  • Address: 600 PROFESSIONAL DR
    SUITE 160B
    LAWRENCEVILLE, GA
    ZIP 30046
  • Phone: (678) 878-4555

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NPI Details

AVVSC LAWRENCEVILLE, LLC is an ambulatory surgical clinic center in Lawrenceville, GA. AVVSC LAWRENCEVILLE, LLC NPI is 1427435007. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

600 PROFESSIONAL DR
SUITE 160B
LAWRENCEVILLE, GA
ZIP 30046-651
Phone: (678) 878-4555
Fax: (678) 878-4556

The provider's authorized official is Amish Tilara .
The authorized official title is President and has the following contact phone number (678) 878-4555.

The CLIA number assigned to this NPI record is 11D2108805 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/2/2015 and was last updated on 6/30/2023.

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
12085R0204XRadiologyVascular & Interventional RadiologyNo
2261QM2500XClinic/CenterMedical SpecialtyNo
3261QR0200XClinic/CenterRadiologyNo
4261QA1903XClinic/CenterAmbulatory SurgicalYes

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
111C0001456MEDICAIDGEORGIA

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: 11/21/2025

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