CLINIC KLINIC NPI 1134793102

NPI Information

NPI: 1134793102
Provider Name: CLINIC KLINIC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 11D2221676

Address:
1750 POWDER SPRINGS RD SW STE 510
MARIETTA, GA
ZIP 30064
Phone: (770) 875-8889
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CLINIC KLINIC is a primary care clinic center in Marietta, GA. CLINIC KLINIC NPI is 1134793102. The provider is registered as an organization entity type.

The provider's business location address is:

1750 POWDER SPRINGS RD SW STE 510
MARIETTA, GA
ZIP 30064-849
Phone: (770) 875-8889

The provider's authorized official is Jean M. Lominy .
The authorized official title is Manager and has the following contact phone number (770) 875-9988.

The CLIA number assigned to this NPI record is 11D2221676 - other - clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/14/2021 and was last updated on 11/16/2021.

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	261QP2300X	Clinic/Center	Primary Care			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

NPI Synchronization or Removal

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