Organization
PREMIER AMBULATORY SURGICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VERNON E SPELLMAN SR. (ADMINISTRATOR)
(678) 872-8750
Entity
Organization
Contact information
Practice address
211 CHICOPEE DR NE, MARIETTA, GA 30060-1269
(678) 872-8750
Mailing address
211 CHICOPEE DR NE, MARIETTA, GA 30060-1269
(678) 872-8750
(678) 872-8769
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
23819
GA
Other
Enumeration date
01/16/2013
Last updated
01/16/2013
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