National Provider Identifier Database

AVVSC LAWRENCEVILLE LLC
Ambulatory Surgical


Contact Information

AVVSC LAWRENCEVILLE, LLC
600 PROFESSIONAL DR
SUITE 160B
LAWRENCEVILLE, GA30046-7651
Phone: 678-878-4555
Fax: 678-878-4556
Website:
Specialty Taxonomy Code
* Ambulatory Surgical 261QA1903X
Medical Specialty 261QM2500X
Radiology 261QR0200X
Vascular & Interventional Radiology 2085R0204X

* Indicates primary specialty

NPI Profile & details for AVVSC LAWRENCEVILLE, LLC

NPI Number 1427435007
Legal business name
LBN
AVVSC LAWRENCEVILLE, LLC
Authorized official AMISH TILARA - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 05/02/2015
Last updated 06/30/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • GA Medicaid: 11C0001456

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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