MEDICARE: EASTSIDE SURGICAL ASSISTANTS 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
1	246ZC0007X	Surgical Assistant

General Provider Information

NPI Number	:	1962872218
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EASTSIDE SURGICAL ASSISTANTS LLC

Provider Business Mailing Address
First Line	:	925 MAIN ST
Second Line	:	SUITE 300-07
City	:	STONE MOUNTAIN
State	:	GA
Zip	:	30083-3098
Country	:	US
Telephone Number	:	678-799-2498
Fax Number	:

Provider Business Practice Location Address
First Line	:	925 MAIN ST
Second Line	:	SUITE 300-07
City	:	STONE MOUNTAIN
State	:	GA
Zip	:	30083-3098
Country	:	US
Telephone Number	:	678-799-2498
Fax Number	:

Authorized Official
Title or Position	:	CERTIFIED SURGICAL ASSISTANT
Name	:	MR. SAMUEL FENDERSON
Credential	:
Telephone Number	:	678-799-2498

Provider Enumeration Date	:	09/30/2015
Last Update Date	:	09/30/2015

Similar Medicare Providers

1609734383 — SHAJEH HOME CARE LLC
Practice Location Address:

925 MAIN ST STE 30021
STONE MOUNTAIN, GA
30083-3098

Practice Phone: 470-469-2850
Practice Fax: 470-469-2850

1619835279 — SHAJEH HOME CARE LLC
Practice Location Address:

925 MAIN ST # 30021
STONE MOUNTAIN, GA
30083-3098

Practice Phone: 470-469-2850
Practice Fax: 470-469-2850

1841486305 — GEORGIA YOUTH NETWORK INC
Practice Location Address:

925 MAIN ST , SUITE 104
STONE MOUNTAIN, GA
30083-3098

Practice Phone: 770-344-8704
Practice Fax: 770-216-1723

1326370545 — MR. SAMUEL FENDERSON
Practice Location Address:

925 MAIN ST # 300-07
STONE MOUNTAIN, GA
30083-3098

Practice Phone: 678-799-2498
Practice Fax:

1063778983 — HERITAGE MEDICAL HOUSE CALL
Practice Location Address:

925 MAIN STREET , SUITE 300-13
STONE MOUNTAIN, GA
30083-3098

Practice Phone: 888-461-9765
Practice Fax: 678-381-1684

1205295425 — PRN SITTERS, LLC
Practice Location Address:

925 MAIN ST , SUITE 300-21
STONE MOUNTAIN, GA
30083-3098

Practice Phone: 770-885-7485
Practice Fax:

Directions to “EASTSIDE SURGICAL ASSISTANTS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.