| Organization Name: | COBB ENDOSCOPY CENTER LLC |
| NPI Number: | 1023102266 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THOMAS J DEMARCO (PRESIDENT) |
| Mailing Address: | 3969 South Cobb Dr Suite 207 Smyrna |
| State: | GA US |
| Postal Code: | 30080 |
| Phone Number: | 7704325326 |
| Fax Number: | 7704325740 |
| NPI Enumeration Date: | 10/03/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QE0800X |
| License Number: | 033225 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Endoscopy |
| Taxonomy Definition: | |