Coosa Procedure Center Llc

LBN: Coosa Procedure Center Llc
Coosa Procedure Center Llc is an health care organization with primary practice located at 18 Riverbend Dr Sw Ste 120 , Rome GA 30161-6019. The organization recently has only one registered license in Ambulatory Health Care Facilities / Ambulatory Surgical, which is considered as the primary health care specialty. Coosa Procedure Center Llc can be contacted via phone (706) 378-1202, or through Holladay, Dawnetta Janene via phone (706) 549-8114.

Contact Information

Primary practice address
18 Riverbend Dr Sw Ste 120 Rome GA 30161-6019
Phone: (706) 378-1202
Fax: (706) 378-1204
Website:
Map and Directions
Authorized official contact:
Name: Holladay, Dawnetta Janene Doctor of Medicine (MD)
Phone: (706) 549-8114

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Ambulatory Surgical 261QA1903X 057288 Georgia

Profile Details

NPI number 1821183237
LBN Legal business name Coosa Procedure Center Llc
DBA Doing business as
Authorized official Holladay, Dawnetta Janene Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 3rd, 2006
Last updated Jan 8th, 2018 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821183237 NPPES
Georgia MEDICAID 196957398A

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