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Contact Information

ACI SURGICAL ASSOCIATES
LBN PROVIDENT HEALTH SURGICAL ASSOCIATES, INC.
4700 WATERS AVE
SUITE 405
SAVANNAH, GA31404-6220
 Phone: 912-350-2700
 Fax: 912-350-2715
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for ACI SURGICAL ASSOCIATES

NPI # 1104113307
LBN Legal business name PROVIDENT HEALTH SURGICAL ASSOCIATES, INC.
DBA Doing business as ACI SURGICAL ASSOCIATES
Authorized official ROBIN MADDOX - (PROVIDER ENROLLMENT COORDINATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 07/08/2011
Last updated 07/08/2011 - About 8 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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