Basic Information
| Provider Information | |||||||||
| NPI: | 1306476197 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | EAMC-LANIER AMBULATORY SURGERY CENTER, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 121 N 20TH ST STE 3 | ||||||||
| Address2: | |||||||||
| City: | OPELIKA | ||||||||
| State: | AL | ||||||||
| PostalCode: | 368015454 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3347456271 | ||||||||
| FaxNumber: | 3347429879 | ||||||||
| Practice Location | |||||||||
| Address1: | 4800 48TH ST | ||||||||
| Address2: | |||||||||
| City: | VALLEY | ||||||||
| State: | AL | ||||||||
| PostalCode: | 368543666 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3347569180 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/21/2020 | ||||||||
| LastUpdateDate: | 02/28/2020 | ||||||||
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| AuthorizedOfficialLastName: | HARPER | ||||||||
| AuthorizedOfficialFirstName: | HOWARD | ||||||||
| AuthorizedOfficialMiddleName: | CLAY | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3347456271 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 02/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.