MEDICARE: KURA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QS0132X	Ophthalmologic Surgery Clinic/Center

General Provider Information

NPI Number	:	1164751749
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KURA LLC

Provider Business Mailing Address
First Line	:	1909 ABERDEEN RD
Second Line	:	STE 108
City	:	ALBANY
State	:	GA
Zip	:	31701-1393
Country	:	US
Telephone Number	:	229-439-7774
Fax Number	:	229-883-8586

Provider Business Practice Location Address
First Line	:	1909 ABERDEEN RD
Second Line	:	STE 108
City	:	ALBANY
State	:	GA
Zip	:	31701-1393
Country	:	US
Telephone Number	:	229-439-7774
Fax Number	:	229-883-8586

Authorized Official
Title or Position	:	OWNER
Name	:	DR. RAJESH RANGARAJ
Credential	:	MD
Telephone Number	:	229-439-7774

Provider Enumeration Date	:	12/10/2009
Last Update Date	:	10/18/2010

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