Provider Demographics
NPI:1326555491
Name:GI NORTH ENDOSCOPY.LLC
Entity Type:Organization
Organization Name:GI NORTH ENDOSCOPY.LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANGER
Authorized Official - Prefix:
Authorized Official - First Name:LENA
Authorized Official - Middle Name:
Authorized Official - Last Name:FONTONOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:705-332-7384
Mailing Address - Street 1:4150 DEPUTY BILL CANTRELL MEMORIAL ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4150 DEPUTY BILL CANTRELL MEMORIAL ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040
Practice Address - Country:US
Practice Address - Phone:404-446-0600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-10
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy