STATESBORO AMBULATORY SURGERY CENTER, INC – NPI #1356619613
Clinic/Center

STATESBORO AMBULATORY SURGERY CENTER, INC is an AHC clinic located in STATESBORO, GA. NPPES has assigned the NPI number 1356619613 to STATESBORO AMBULATORY SURGERY CENTER, INC on December 01, 2011. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for STATESBORO AMBULATORY SURGERY CENTER, INC below.

NPI Profile for
STATESBORO AMBULATORY SURGERY CENTER, INC

NPI Number
1356619613
Enumeration Date

(more than 14 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
STATESBORO AMBULATORY SURGERY CENTER, INC
Primary location
95 BEL AIR DRIVE
STATESBORO, GA 30461
Phone: (912) 489-6519 Fax: (912) 764-7882
Mailing address
95 BEL AIR DR
STATESBORO, GA 30461-6879
Phone: (912) 489-6519 Fax: (912) 764-7882
Organization Subpart
No
Authorized Official
ROBERT CUSHNER
CEO/OWNER
Phone: (912) 489-8727
Updated
Identifiers

Identifiers for STATESBORO AMBULATORY SURGERY CENTER, INC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERPROVIDER TRANSACTION ACCESS NUMBERGRP4317
MEDICAIDGA000624896A
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.