Provider Demographics
NPI:1437289535
Name:BI-CITY SURGICAL CENTRE, INC.
Entity Type:Organization
Organization Name:BI-CITY SURGICAL CENTRE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:ASANTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-327-5300
Mailing Address - Street 1:1900 10TH AVE
Mailing Address - Street 2:SUITE 305A
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-3600
Mailing Address - Country:US
Mailing Address - Phone:706-327-5300
Mailing Address - Fax:706-317-4203
Practice Address - Street 1:1900 10TH AVE
Practice Address - Street 2:SUITE 305A
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-3600
Practice Address - Country:US
Practice Address - Phone:706-327-5300
Practice Address - Fax:706-317-4203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000628261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherCHAMPUS
=========OtherCHAMPUS