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General NPI Number Information
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NPI Number | 1003144353
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Entity Type | Organization
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Legal Business Name | PIEDMONT WEST AMBULATORY SURGERY CENTER
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Dates
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Enumeration Date | 11/25/2009
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Last Update Date | 11/25/2009
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Provider Practice Location Address
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Address Line | 1800 HOWELL MILL RD NW SUITE 250
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City | ATLANTA
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State | GA
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Zip | 30318-2538
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Country | US
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Telephone | 404-317-2694
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Fax | 770-234-5352
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Provider Business Mailing Address
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Address Line | 1800 HOWELL MILL RD NW SUITE 250
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City | ATLANTA
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State | GA
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Zip | 30318-2538
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Country | US
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Telephone | 404-317-2694
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Fax | 770-234-5352
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Authorized Official
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Title or Position | BUSINESS OPERATIONS MANAGER
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Name | MRS. TINA J KING
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Credential |
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Telephone | 404-317-2694
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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