Provider Demographics
NPI:1508500273
Name:GASTROINTESTINAL ASSOCIATES ENDOSCOPY CENTER, LLC
Entity Type:Organization
Organization Name:GASTROINTESTINAL ASSOCIATES ENDOSCOPY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:COHRS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-847-2558
Mailing Address - Street 1:411 WESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-4152
Mailing Address - Country:US
Mailing Address - Phone:715-847-2558
Mailing Address - Fax:715-261-6452
Practice Address - Street 1:3225 BUSINESS PARK DR
Practice Address - Street 2:
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54482-8837
Practice Address - Country:US
Practice Address - Phone:877-442-7762
Practice Address - Fax:715-847-2557
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GASTROINTESTINAL ASSOCIATES ENDOSCOPY CENTER, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-27
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical