Provider Demographics
NPI:1356314249
Name:COLUMBIA ASC LLC
Entity Type:Organization
Organization Name:COLUMBIA ASC LLC
Other - Org Name:COLUMBIA GASTROINTESTINAL ENDOSCOPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:SNODGRASS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-665-1283
Mailing Address - Street 1:1A BURTON HILLS BLVD
Mailing Address - Street 2:ATTN: L&C
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6103
Mailing Address - Country:US
Mailing Address - Phone:803-254-9588
Mailing Address - Fax:803-931-8085
Practice Address - Street 1:2739 LAUREL ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-2028
Practice Address - Country:US
Practice Address - Phone:803-254-9588
Practice Address - Fax:803-931-8085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-10
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCASF-032261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCASC008Medicaid
SC490003062Medicare PIN
SC42-C0001013Medicare Oscar/Certification
SCQ313900001Medicare PIN