Provider Demographics
NPI:1356596746
Name:NOVAMED SURGERY CENTER OF BEDFORD, LLC
Entity type:Organization
Organization Name:NOVAMED SURGERY CENTER OF BEDFORD, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP
Authorized Official - Prefix:
Authorized Official - First Name:GRAHAM
Authorized Official - Middle Name:B
Authorized Official - Last Name:CHERRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-240-0965
Mailing Address - Street 1:11800 AMBER PARK DRIVE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-0000
Mailing Address - Country:US
Mailing Address - Phone:678-240-0965
Mailing Address - Fax:678-240-0971
Practice Address - Street 1:105 RIVERWAY PL
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6730
Practice Address - Country:US
Practice Address - Phone:603-627-9540
Practice Address - Fax:603-668-7952
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NOVAMED, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-26
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty