Organization
MAINESTATE SURGICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VERNON GEORGE ROUZEAU-SAUNDERS RN, RNFA (CEO)
(678) 332-8596
Entity
Organization
Contact information
Practice address
1720 SHIRE VILLAGE DR, SUGAR HILL, GA 30518-2922
(678) 332-8596
Mailing address
1720 SHIRE VILLAGE DR, SUGAR HILL, GA 30518-2922
(678) 332-8596
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
16052680
GA
Other
Enumeration date
06/15/2016
Last updated
06/15/2016
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