Organization
FORSYTH STREET AMBULATORY SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMMY MICHELLE HODGE RN (ADMINISTRATOR)
(478) 749-1610
Entity
Organization
Contact information
Practice address
1610 FORSYTH STREET, MACON, GA 31201
(478) 749-1610
(478) 841-3150
Mailing address
1610 FORSYTH STREET, MACON, GA 31201
(478) 749-1610
(478) 841-3150
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00622117
RAILROAD MEDICARE
GA
Enumeration date
01/24/2007
Last updated
03/27/2013
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