Provider Demographics
NPI:1831301050
Name:THE WOMEN'S SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:THE WOMEN'S SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-871-3000
Mailing Address - Street 1:PO BOX 1958
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30459-1958
Mailing Address - Country:US
Mailing Address - Phone:912-871-3000
Mailing Address - Fax:912-871-3100
Practice Address - Street 1:1523 FAIR RD
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-6025
Practice Address - Country:US
Practice Address - Phone:912-871-3000
Practice Address - Fax:912-871-3100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA016-232261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA111201ASCAMedicare ID - Type UnspecifiedMEDICARE FACILITY NUMBER