Healthcare Provider Details

I. General information

NPI: 1881151108
Provider Name (Legal Business Name): ALLIANCE SURGERY CENTER AT JOHNS CREEK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2019
Last Update Date: 02/29/2020
Certification Date: 02/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6920 MCGINNIS FERRY RD STE 360A
SUWANEE GA
30024-6672
US

IV. Provider business mailing address

PO BOX 11407 DEPT 8099
BIRMINGHAM AL
35246-0001
US

V. Phone/Fax

Practice location:
  • Phone: 404-920-4950
  • Fax: 404-920-4959
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VICTORIA BECK
Title or Position: CFO
Credential:
Phone: 404-920-4950