COOSA PROCEDURE CENTER LLC NPI 1821183237

NPI Information

NPI: 1821183237
Provider Name: COOSA PROCEDURE CENTER LLC
Classification: Clinic/Center - 261QA1903X
Specialization: Ambulatory Surgical
Entity Type: Organization
Address: 18 RIVERBEND PKWY
SUITE 120
ROME, GA
ZIP 30161
Phone: (706) 549-8114

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NPI Details

COOSA PROCEDURE CENTER LLC is an ambulatory surgical clinic center in Rome, GA. COOSA PROCEDURE CENTER LLC NPI is 1821183237. The provider is registered as an organization entity type.

The provider's business location address is:

18 RIVERBEND PKWY
SUITE 120
ROME, GA
ZIP 30161
Phone: (706) 549-8114
Fax: (706) 549-0151

The provider's authorized official is Dawnetta Janene Holladay .
The authorized official title is Ceo and has the following contact phone number (706) 549-8114.

The enumeration date for this NPI number is 10/3/2006 and was last updated on 1/8/2018.

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	057288	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	196957398A	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: 11/21/2025

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