Bca Georgia, Llc

NPI Registration Record

Provider / Organization	NPI	Date Certified
BCA GEORGIA, LLC	1679294227	2023-02-10

The organization Bca Georgia, Llc is registered with the National Plan and Provider Enumeration System (NPPES) and has the assigned NPI of 1679294227. Registration indicates Bca Georgia, Llc is a provider of services with a specialization in Ambulatory Health Care Facilities, Clinic/Center (Clinic/Center: Radiology, ) (Diagnostics/Imaging/Laboratory/Mammography, ) (Clinic/Center Radiology, Ambulatory Health Care Facilities) (Clinic/Center, )

Other Names:

• Lakeside Imaging

Entity Type	Organization
Provider Organization	BCA GEORGIA, LLC
Other Provider Organization	LAKESIDE IMAGING
Practice Office Address	1850 N COLUMBIA ST STE 3 MILLEDGEVILLE, GA US
Practice Office Telephone	4784534101
Mailing Address	PO BOX 1067 STATESBORO, GA 304591067 US
Business Telephone	9127642455
Business Fax	9127647522
Authorized Official	GARY HARPER DENT, CEO 9127642455

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