Provider Demographics
NPI:1053509885
Name:AMIS SURGICAL ASSISTANTS LLC
Entity Type:Organization
Organization Name:AMIS SURGICAL ASSISTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:ALCINA
Authorized Official - Suffix:
Authorized Official - Credentials:CFA
Authorized Official - Phone:985-518-2207
Mailing Address - Street 1:PO BOX 2611
Mailing Address - Street 2:
Mailing Address - City:MORGAN CITY
Mailing Address - State:LA
Mailing Address - Zip Code:70381-2611
Mailing Address - Country:US
Mailing Address - Phone:985-518-2207
Mailing Address - Fax:888-329-6432
Practice Address - Street 1:1649 CHESTNUT DR
Practice Address - Street 2:
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380-1622
Practice Address - Country:US
Practice Address - Phone:985-518-2207
Practice Address - Fax:888-329-6432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty