LIFEQUEST EAST MARIETTA LLC NPI 1023424181

NPI Information

NPI: 1023424181
Provider Name: LIFEQUEST EAST MARIETTA LLC

Doing Business As: ENERGY MEDICAL GROUP

Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

Address:
4930 DAVIDSON RD NE
100
MARIETTA, GA
ZIP 30068
Phone: (678) 973-0635
Get Directions

LIFEQUEST EAST MARIETTA LLC is a health service clinic center in Marietta, GA. LIFEQUEST EAST MARIETTA LLC NPI is 1023424181. The provider is registered as an organization entity type.
The provider Is Doing Business As Energy Medical Group.

The provider's business location address is:

4930 DAVIDSON RD NE
100
MARIETTA, GA
ZIP 30068-661
Phone: (678) 973-0635

The provider's authorized official is James Broussard .
The authorized official title is Vice President and has the following contact phone number (678) 973-0635.

The enumeration date for this NPI number is 7/9/2014 and was last updated on 7/9/2014.

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
1	261QH0100X	Clinic/Center	Health Service	33753	GEORGIA	Yes

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: 4/28/2024

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