Spivey Station Surgery Center

LBN: Southlake Ambulatory Surgery Center, Lllp
Spivey Station Surgery Center is an health care organization with primary practice located at 7813 Spivey Station Blvd Suite 100, Jonesboro GA 30236-0000. The organization recently has only one registered license in Ambulatory Health Care Facilities / Ambulatory Surgical, which is considered as the primary health care specialty. Southlake Ambulatory Surgery Center, Lllp can be contacted via phone (770) 268-6000, or through Mclain, John R via phone (770) 991-8000.

Contact Information

Primary practice address
7813 Spivey Station Blvd Suite 100 Jonesboro GA 30236-0000
Phone: (770) 268-6000
Fax: (770) 268-6001
Website:
Map and Directions
Authorized official contact:
Name: Mclain, John R
Phone: (770) 991-8000

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Ambulatory Surgical 261QA1903X 031127 Georgia

Profile Details

NPI number 1508974353
LBN Legal business name Southlake Ambulatory Surgery Center, Lllp
DBA Doing business as Spivey Station Surgery Center
Authorized official Mclain, John R
Entity Organization
Organization subpart 1 No
Enumeration date Aug 29th, 2006
Last updated Jul 25th, 2013 - about 13 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 1508974353 NPPES
Georgia MEDICAID 00973046A
Georgia MEDICAID 306743

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