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NPI Code Detail

MEDICARE: CHILDREN'S SEDATION SERVICES, LLC

MEDICARE: CHILDREN'S SEDATION SERVICES, 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
1363A00000XPhysician Assistant
2367500000XCertified Registered Nurse Anesthetist
3207LC0200XCritical Care Medicine (Anesthesiology) Physician

General Provider Information

NPI Number : 1740334291
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHILDREN'S SEDATION SERVICES, LLC
Provider Business Mailing Address
First Line : 1575 NORTHEAST EXPY NE
Second Line :
City : BROOKHAVEN
State : GA
Zip : 30329-2401
Country : US
Telephone Number : 404-785-7928
Fax Number :
Provider Business Practice Location Address
First Line : 1575 NORTHEAST EXPY NE
Second Line :
City : BROOKHAVEN
State : GA
Zip : 30329-2401
Country : US
Telephone Number : 404-785-6000
Fax Number :
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : RUTH FOWLER
Credential :
Telephone Number : 404-785-5437
Provider Enumeration Date : 01/22/2007
Last Update Date : 10/17/2025

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Directions to “CHILDREN'S SEDATION SERVICES, LLC ” Practice Location

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