Provider Demographics
NPI:1841459211
Name:AASC, LLC
Entity type:Organization
Organization Name:AASC, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:CLOTFELTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-233-3833
Mailing Address - Street 1:4200 NORTHSIDE PKWY NW BLDG 8
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-3054
Mailing Address - Country:US
Mailing Address - Phone:404-233-3833
Mailing Address - Fax:404-233-8447
Practice Address - Street 1:4200 NORTHSIDE PKWY NW BLDG 8
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-3054
Practice Address - Country:US
Practice Address - Phone:404-233-3833
Practice Address - Fax:404-233-8447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-02
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA027-89261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD39781Medicare UPIN