Provider Demographics
NPI:1942507488
Name:GA ENDOSCOPY CENTER, LLC
Entity Type:Organization
Organization Name:GA ENDOSCOPY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:COLLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMAISTRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-250-3640
Mailing Address - Street 1:3330 PRESTON RIDGE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-4508
Mailing Address - Country:US
Mailing Address - Phone:404-255-1000
Mailing Address - Fax:404-847-0416
Practice Address - Street 1:3330 PRESTON RIDGE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4508
Practice Address - Country:US
Practice Address - Phone:404-255-1000
Practice Address - Fax:404-847-0416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-18
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA060-260261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical