Basic Information
| Provider Information | |||||||||
| NPI: | 1083695860 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ELMS ENDOSCOPY CENTER LLC | ||||||||
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| OtherOrganizationName: | ELMS ENDOSCOPY CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1A BURTON HILLS BLVD | ||||||||
| Address2: | ATTN: L&C | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372156103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8437976800 | ||||||||
| FaxNumber: | 8437976825 | ||||||||
| Practice Location | |||||||||
| Address1: | 2671 ELMS PLANTATION BLVD | ||||||||
| Address2: | |||||||||
| City: | NORTH CHARLESTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294069165 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8437976800 | ||||||||
| FaxNumber: | 8437976825 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2005 | ||||||||
| LastUpdateDate: | 06/28/2022 | ||||||||
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| AuthorizedOfficialLastName: | SNODGRASS | ||||||||
| AuthorizedOfficialFirstName: | JEFFREY | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6156651283 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| NPICertificationDate: | 06/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QE0800X | Y | Ambulatory Health Care Facilities | Clinic/Center | Endoscopy |
No ID Information.