Provider Demographics
NPI:1215410592
Name:ALLIANCE SURGERY CENTER AT WOODSTOCK, LLC
Entity Type:Organization
Organization Name:ALLIANCE SURGERY CENTER AT WOODSTOCK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-403-8310
Mailing Address - Street 1:PO BOX 11407 DEPT 8082
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35246-0001
Mailing Address - Country:US
Mailing Address - Phone:404-920-4950
Mailing Address - Fax:404-920-4959
Practice Address - Street 1:300 PARKBROOKE PL STE 390
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-7209
Practice Address - Country:US
Practice Address - Phone:770-929-9033
Practice Address - Fax:770-929-9092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-12
Last Update Date:2020-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical