Provider Demographics
NPI:1437183365
Name:THOMASVILLE SURGERY CENTER, INC.
Entity Type:Organization
Organization Name:THOMASVILLE SURGERY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:LAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-226-6000
Mailing Address - Street 1:2282 E. PINETREE BLVD, SUITE B
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-4807
Mailing Address - Country:US
Mailing Address - Phone:229-226-6000
Mailing Address - Fax:229-226-5859
Practice Address - Street 1:2282 E PINETREE BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-4807
Practice Address - Country:US
Practice Address - Phone:229-226-6000
Practice Address - Fax:229-226-5859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA11C0001180261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
2271842OtherUNITED HEALTHCARE
490004937OtherRAILROAD MEDICARE
GA51404873OtherBLUE CROSS
GAGRP3917OtherMEDICARE GROUP NUMBER
GA000896255AMedicaid
GA111180ASCAMedicare PIN