VALDOSTA ENDOSCOPY CENTER, LLC; NPI #1831134121

Contact Information

VALDOSTA ENDOSCOPY CENTER, LLC

410 CONNELL RD
VALDOSTA, GA 31602-1407

Phone: 229-244-1570
Fax: 229-247-1084
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Endoscopy	261QE0800X

Indicates primary specialty

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NPI Profile & details for VALDOSTA ENDOSCOPY CENTER, LLC

NPI Number 1831134121

LBN Legal business name VALDOSTA ENDOSCOPY CENTER, LLC

Authorized official ERIC WARD - (PHYSICIAN)

Entity Organization

Organization subpart ¹ No

Enumeration date 06/19/2006

Last updated 06/08/2012 - About 14 years ago

Identifiers

GA	License #	092-243
GA	Medicaid	000960473A

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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