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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 Specialty Code Provider Type

Ambulatory Surgical

261QA1903X 49 Ambulatory Surgical Center
 

Medical Specialty

261QM2500X
 

Radiology

261QR0200X 74 Radiation Therapy Center
 

Vascular & Interventional Radiology

2085R0204X 94 Physician/Interventional Radiology
Indicates primary specialty

NPI Profile & details for AVVSC LAWRENCEVILLE, LLC

NPI # 1427435007
LBN Legal business name AVVSC LAWRENCEVILLE, LLC
Authorized official AMISH TILARA - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 05/02/2015
Last updated 06/30/2023 - About 3 years ago
Identifiers
GA Medicaid 11C0001456
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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