SE COSTAL LASER SERVICES, LLC (NPI# 1215115316) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1215115316 |
Entity Type | Organization |
Organization Name | SE COSTAL LASER SERVICES, LLC |
Practice Address |
2351 College Station Rd Athens GA 30605-3619 |
Mailing Address |
6339 E Speedway Blvd Suite 201 Tucson AZ 85710-1147 |
Practice Telephone | 5205474130 |
Practice Fax Number | 5202580304 |
Mailing Telephone | 5205474130 |
Mailing Fax Number | 5202580304 |
Enumeration Date | 2008-01-31 |
Last Update Date | 2008-06-06 |
Authorized Official Name | MARY ANN EVANOSKI (BILLING MANAGER) |
Authorized Official Telephone | 5205474130 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
Street Address |
2351 COLLEGE STATION RD |
City | ATHENS |
State | GA |
Zip Code | 30605-3619 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043498199 | Athens Lithotrispy, LLC | Clinic/Center | 2351 College Station Rd, Suite 558, Athens, GA 30605-3619 | 2008-01-31 |
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1194245423 | Melissa Brooke Wilson | Speech-Language Pathologist | 345 Research Drive Apartment 76, Athens, GA 30605 | 2017-06-27 |
1467982512 | Beth Kay Mcdonald | Counselor | 455 S Lumpkin St, Athens, GA 30605 | 2017-06-12 |
1841741063 | Jessica Parker | Specialist | 1060 Gaines School Rd, Suite A4c, Athens, GA 30605 | 2016-10-24 |
1417374869 | Northeast Georgia Wellness Associates, LLC | Dietitian, Registered | 1197 Cedar Shoals Drive #103, Athens, GA 30605 | 2014-03-24 |
1245571272 | Optimum Medical Healthcare | Durable Medical Equipment & Medical Supplies | 1715 Cedar Shoals Drive, Athens, GA 30605 | 2013-03-15 |
1972850709 | Sandra Joy Motte | Occupational Therapy Assistant | 275 Woodgrove Dr, Athens, GA 30605 | 2012-08-10 |
1124309851 | Kasey Brown | Social Worker | 188 S. Milledge Ave., Suite 2, Athens, GA 30605 | 2011-09-08 |
1154652071 | Chris Mayo Counseling and Psychotherapy, Lcsw, LLC | Social Worker | 135 Milford Dr, Athens, GA 30605 | 2010-01-15 |
1700039732 | Andrew Case | Psychologist | 105a Cedar Rock Trace, Suite 5, Athens, GA 30605 | 2008-11-04 |
Find all providers in zip 30605 |
Taxonomy Code | 261QA1903X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Ambulatory Surgical |
Definition to come... |
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1649790171 | Athens Spine Procedural Center LLC | Clinic/Center | 1550 Timothy Rd Ste 103, Athens, GA 30606-7836 | 2017-06-26 |
1265709968 | Lumpkin Surgery Center | Clinic/Center | 1300 Crystal Hills Dr, Athens, GA 30606-5304 | 2011-11-23 |
1962453175 | The Surgery Center of Athens, LLC. | Clinic/Center | 105 N Meadows Dr, Athens, TN 37303-4172 | 2006-05-12 |
1033583836 | Advanced Gynecologic Surgery Center | Clinic/Center | 1000 Hawthorne Ave, Suite V, Athens, GA 30606-2168 | 2015-11-18 |
1700269354 | Southeast Ohio Surgical Suites, LLC | Clinic/Center | 20 University Estates Blvd, Suite 110, Athens, OH 45701-2869 | 2015-07-01 |
1801277819 | Hawthorne Surgery Center LLC | Clinic/Center | 1000 Hawthorne Ave, Suite U, Athens, GA 30606-2168 | 2015-06-16 |
1316290380 | Athens Surgery Center LLC | Clinic/Center | 105 N Meadows Dr, Athens, TN 37303-4172 | 2012-10-16 |
1508135658 | Surgery Center of Athens LLC | Clinic/Center | 2142 W Broad St, Suite 100, Athens, GA 30606-3546 | 2011-12-19 |
1699057810 | Oral & Maxillofacial Surgery Center of Athens, LLC | Clinic/Center | 600 Oglethorpe Ave, Suite 4, Athens, GA 30606-2263 | 2011-09-13 |
Find all providers in ATHENS |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.