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General NPI Number Information
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NPI Number | 1235510595
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Entity Type | Organization
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Legal Business Name | SAGACITY SURGICAL GROUP LLC
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Dates
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Enumeration Date | 06/12/2015
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Last Update Date | 01/28/2022
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Provider Practice Location Address
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Address Line | 227 SANDY SPRINGS PL STE D-53
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City | SANDY SPRINGS
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State | GA
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Zip | 30328-5918
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Country | US
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Telephone | 214-227-2457
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Fax | 214-764-0880
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Provider Business Mailing Address
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Address Line | 227 SANDY SPRINGS PL STE D-53
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City | SANDY SPRINGS
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State | GA
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Zip | 30328-5918
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Country | US
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Telephone | 214-227-2457
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Fax | 214-764-0880
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Authorized Official
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Title or Position | OWNER
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Name | EMMANUEL A RIVERS SR.
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Credential | CSA
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Telephone | 404-453-6757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZS0410X
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Taxonomy Name | Surgical Technologist
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License Number | 86829
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 246ZX2200X
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Taxonomy Name | Orthopedic Assistant
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License Number | 2748
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 2748
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License Number State | GA
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