Provider Demographics
NPI:1922250356
Name:IAS SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:IAS SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ARMITAGE
Authorized Official - Last Name:RUSCA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-252-3672
Mailing Address - Street 1:5549 GLENRIDGE DR NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1327
Mailing Address - Country:US
Mailing Address - Phone:404-252-3672
Mailing Address - Fax:404-252-3654
Practice Address - Street 1:5549 GLENRIDGE DR NE
Practice Address - Street 2:SUITE 100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1327
Practice Address - Country:US
Practice Address - Phone:404-252-3672
Practice Address - Fax:404-252-3654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical