MEDICARE: SURGICAL ASSISTING SERVICES, INC

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	163WR0006X	Registered Nurse First Assistant	RN063675	GA

General Provider Information

NPI Number	:	1790829711
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SURGICAL ASSISTING SERVICES, INC

Provider Business Mailing Address
First Line	:	1861 DANBURY CT
Second Line	:
City	:	POWDER SPRINGS
State	:	GA
Zip	:	30127-1291
Country	:	US
Telephone Number	:	770-851-1459
Fax Number	:	404-806-4266

Provider Business Practice Location Address
First Line	:	1861 DANBURY CT
Second Line	:
City	:	POWDER SPRINGS
State	:	GA
Zip	:	30127-1291
Country	:	US
Telephone Number	:	770-851-1459
Fax Number	:	404-806-4266

Authorized Official
Title or Position	:	CEO
Name	:	NERISSA P DELISLE
Credential	:	CRNFA
Telephone Number	:	770-891-1459

Provider Enumeration Date	:	02/16/2007
Last Update Date	:	08/22/2020

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