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Organization

THE SURGERY CENTER OF GEORGIA, LLC

Active
Other names
Advanced Surgery Center of Georgia,LLC
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JUDITH GRADY R.N. (ADMINISTRATOR)
(770) 479-2202
Entity
Organization

Contact information

Practice address
220 HOSPITAL RD, CANTON, GA 30114-2407
(770) 479-2202
(770) 479-3891
Mailing address
220 HOSPITAL RD, CANTON, GA 30114-2407
(770) 479-2202
(770) 479-3891

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000659733A
GA
01
1282933
UNITED HEALTHCARE
GA
Enumeration date
06/09/2005
Last updated
07/14/2008
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