Provider Demographics
NPI:1033126222
Name:ENDOSCOPY CENTER OF COLUMBUS, LLC
Entity Type:Organization
Organization Name:ENDOSCOPY CENTER OF COLUMBUS, LLC
Other - Org Name:ENDOSCOPY CENTER OF COLUMBUS, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PRAVINCHANDRA
Authorized Official - Middle Name:H
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-327-0700
Mailing Address - Street 1:1130 TALBOTTON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-8749
Mailing Address - Country:US
Mailing Address - Phone:706-641-6900
Mailing Address - Fax:706-327-0757
Practice Address - Street 1:1130 TALBOTTON RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-8745
Practice Address - Country:US
Practice Address - Phone:706-641-6900
Practice Address - Fax:706-327-0757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy