FAMILY MEDICINE OF POOLER LLC NPI 1275848533

NPI Information

NPI: 1275848533
Provider Name: FAMILY MEDICINE OF POOLER, LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 11D2014321

Address:
433 US HIGHWAY 80 W
POOLER, GA
ZIP 31322
Phone: (912) 748-1100
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FAMILY MEDICINE OF POOLER, LLC is a primary care clinic center in Pooler, GA. FAMILY MEDICINE OF POOLER, LLC NPI is 1275848533. The provider is registered as an organization entity type.

The provider's business location address is:

433 US HIGHWAY 80 W
POOLER, GA
ZIP 31322-509
Phone: (912) 748-1100
Fax: (912) 748-1004

The provider's authorized official is Christi Marie Ghaleb .
The authorized official title is Co-owner and has the following contact phone number (912) 303-9907.

The CLIA number assigned to this NPI record is 11D2014321 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/11/2010 and was last updated on 8/11/2010.

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	056554	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: 5/5/2024

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