GASTROINTESTINAL DIAGNOSTIC ENDOSCOPY WOODSTOCK, LLC (NPI# 1760778765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760778765 |
| Entity Type | Organization |
| Organization Name | GASTROINTESTINAL DIAGNOSTIC ENDOSCOPY WOODSTOCK, LLC |
| Other Organization Name | TOWN LAKE ENDOSCOPY CENTER |
| Practice Address |
118 Mill St Suite 100 Woodstock GA 30188-4879 |
| Mailing Address |
2550 Windy Hill Rd Se Suite 302 Marietta GA 30067-8665 |
| Practice Telephone | 7702269070 |
| Practice Fax Number | 7702268863 |
| Mailing Telephone | 6787415000 |
| Mailing Fax Number | 6787412301 |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2015-03-11 |
| Authorized Official Name | DEBORA S ROWELL (MANAGER) |
| Authorized Official Telephone | 6787412317 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QE0800X |
Clinic/Center Specialization: Endoscopy |
Ambulatory Health Care Facilities | ||
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
028-451 | GA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Town Lake Endoscopy Center | Doing Business As Name - Organization |
| Street Address |
118 MILL ST SUITE 100 |
| City | WOODSTOCK |
| State | GA |
| Zip Code | 30188-4879 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730715814 | Tyler Rose | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 116 South Mill Creek Court, Woodstock, GA 30188 | 2020-03-20 |
| 1881224897 | Dr. Tom LLC | Clinic/Center | 5431 Old Highway 5 Ste 206, Holly Springs, GA 30188 | 2020-01-17 |
| 1467090175 | Stacey Robin Hill | Dietitian, Registered | 210 Mcaffee St, Street Address 2, Woodstock, GA 30188 | 2019-12-12 |
| 1326681784 | Margo Vanderveen | Massage Therapist | 605 Old Hickory Road, Woodstock, GA 30188 | 2019-10-17 |
| 1275093437 | Rebekah Ruth Tchouta | Social Worker | 5166 Shotwell St, Woodstock, GA 30188 | 2019-03-23 |
| 1205395829 | Angela M Graves | Behavior Technician | 3229 S Cherokee Ln Ste 1400, Woodstock, GA 30188 | 2019-03-13 |
| 1396233391 | Costco Wholesale Corporation | Hearing Aid Equipment | 113 Lincoln Street, Woodstock, GA 30188 | 2018-04-25 |
| 1659878080 | Alexis K. Brown | Counselor | 3380 Trickum Rd., Bldg 700, Woodstock, GA 30188 | 2018-04-11 |
| 1427555440 | Lisa Marie Anthony | Specialist/Technologist | 400 Arnold Mill Rd, Woodstock, GA 30188 | 2018-04-06 |
| 1497254122 | J.a.h. Enterprises, LLC | Audiologist | 12195 Hwy. 92, Suite 114-325, Woodstock, GA 30188 | 2018-02-08 |
| Find all providers in zip 30188 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215410592 | Alliance Surgery Center At Woodstock, LLC | Clinic/Center | 300 Parkbrooke Pl Ste 390, Woodstock, GA 30189-7209 | 2018-09-12 |
| 1770911463 | Salubrious Asc, LLC | Clinic/Center | 240 Heritage Walk, Suite 101, Woodstock, GA 30188-3875 | 2013-10-16 |
| 1982978466 | Northwest Ent Surgery Center, LLC | Clinic/Center | 960 Woodstock Pkwy, Suite 101, Woodstock, GA 30188-4866 | 2012-03-01 |
| 1528119252 | Samson Pain Center | Clinic/Center | 120 Stonebridge Pkwy, Suite 420, Woodstock, GA 30189-3767 | 2007-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598372963 | Alliance Surgery Center At Peachtree City LLC | Clinic/Center | 1975 Highway 54 W Ste 105, Peachtree City, GA 30269-4794 | 2020-09-29 |
| 1518579903 | Amin Surgery Center for Women LLC | Clinic/Center | 1150b Kirkland Ln, Douglas, GA 31533-2044 | 2020-08-18 |
| 1801413174 | Pa-c Surgical Assist, LLC | Clinic/Center | 520 W Ponce Leon Ave #1706, Decatur, GA 30030 | 2020-07-02 |
| 1720602683 | Georgia Eye Surgery LLC | Clinic/Center | 1620 Prince Ave Ste B, Athens, GA 30606-6008 | 2020-06-05 |
| 1750905618 | Rsps Fayetteville Asc Lllp | Clinic/Center | 874 Lanier Ave W Ste 270, Fayetteville, GA 30214-7617 | 2020-06-05 |
| 1699395541 | Medici Surgical Center Gwinnett, LLC | Clinic/Center | 2220 Wisteria Dr Ste 100, Snellville, GA 30078-4604 | 2020-04-21 |
| 1114552338 | Georgia Interventional Pain - G, LLC | Clinic/Center | 1504 N Thornton Ave Ste 104, Dalton, GA 30720-8394 | 2020-03-09 |
| 1700424322 | Georgia Interventional Pain - F, LLC | Clinic/Center | 1357 Hembree Rd Ste 230, Roswell, GA 30076-5725 | 2019-12-13 |
| 1699328369 | Georgia Urology, Pa | Clinic/Center | 1670 Scott Blvd Ste 204k, Decatur, GA 30033-5645 | 2019-07-22 |
| 1912563941 | Commerce Ambulatory Surgery Center, Inc. | Clinic/Center | 417 Pottery Factory Dr, Commerce, GA 30529-6682 | 2019-05-15 |
| Find all providers with the same taxonomy | ||||
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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.