1356596746 NPI number — NOVAMED SURGERY CENTER OF BEDFORD, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356596746 NPI number — NOVAMED SURGERY CENTER OF BEDFORD, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NOVAMED SURGERY CENTER OF BEDFORD, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NH EYE SURGICENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356596746
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/26/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11800 AMBER PARK DRIVE
Provider Second Line Business Mailing Address:
SUITE 240
Provider Business Mailing Address City Name:
ALPHARETTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30009-0000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
678-240-0965
Provider Business Mailing Address Fax Number:
678-240-0971

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
105 RIVERWAY PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BEDFORD
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03110-6730
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-627-9540
Provider Business Practice Location Address Fax Number:
603-668-7952
Provider Enumeration Date:
11/26/2008

Additional Information

Authorized Official

Authorized Official Last Name:
CHERRINGTON
Authorized Official First Name:
GRAHAM
Authorized Official Middle Name:
B.
Authorized Official Title or Position:
SENIOR VP
Authorized Official Telephone Number:
678-240-0965

Provider Taxonomy Codes

  • Taxonomy code: 367500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com