NORTHLAKE ENDOSCOPY CENTER – NPI #1871594499
Clinic/Center

NORTHLAKE ENDOSCOPY CENTER is an AHC clinic located in TUCKER, GA. NPPES has assigned the NPI number 1871594499 to NORTHLAKE ENDOSCOPY CENTER on August 04, 2005. 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

The NPI profile was previously updated about 18 years ago on May 08, 2008. 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 NORTHLAKE ENDOSCOPY CENTER below.

NPI Profile for
NORTHLAKE ENDOSCOPY CENTER

NPI Number
1871594499
Enumeration Date

(about 21 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
NORTHLAKE ENDOSCOPY CENTER
Primary location
1459 MONTREAL RD
SU 204
TUCKER, GA 30084-6900
Phone: (770) 939-4721 Fax: (770) 939-1187
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
RALPH BETON
PRESIDENT
Phone: (770) 939-4721
Updated
Identifiers

Identifiers for NORTHLAKE ENDOSCOPY CENTER

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
MEDICAIDGA000468652A
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)		 GA 044047

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.