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CARITAS MEDICAL CENTER FAYETTEVILLE LLC NPI 1801572003


NPI Information

NPI: 1801572003
Provider Name: CARITAS MEDICAL CENTER FAYETTEVILLE LLC
Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

CLIA Number: 11D2292799

Address:
105 N PARK TRL STE 300
STOCKBRIDGE, GA
ZIP 30281
Phone: (678) 284-0800
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CARITAS MEDICAL CENTER FAYETTEVILLE LLC is a nephrology internal medicine in Stockbridge, GA. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. CARITAS MEDICAL CENTER FAYETTEVILLE LLC NPI is 1801572003. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

105 N PARK TRL STE 300
STOCKBRIDGE, GA
ZIP 30281-432
Phone: (678) 284-0800
Fax: (678) 284-9299

The provider's authorized official is Veraline Ovadje .
The authorized official title is Office Manager and has the following contact phone number (678) 284-0800.

The CLIA number assigned to this NPI record is 11D2292799 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/23/2023 and was last updated on 6/23/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RN0300XInternal MedicineNephrologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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