Provider Demographics
NPI:1912639147
Name:KANDER SURGICAL ASSISTING, LLC
Entity Type:Organization
Organization Name:KANDER SURGICAL ASSISTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CSA
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIARA
Authorized Official - Middle Name:QUANTANEE'
Authorized Official - Last Name:HUFF
Authorized Official - Suffix:
Authorized Official - Credentials:CSA
Authorized Official - Phone:762-215-5689
Mailing Address - Street 1:1622 WATERFORD LNDG
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-7726
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1622 WATERFORD LNDG
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-7726
Practice Address - Country:US
Practice Address - Phone:762-215-5689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty