GENESIS VASCULAR OF POOLER LLC NPI 1376930339

NPI Information

  • NPI: 1376930339
  • Provider Name: GENESIS VASCULAR OF POOLER, LLC
  • Classification: Internal Medicine - 207RI0011X
  • Specialization: Interventional Cardiology
  • Entity Type: Organization
  • Other Name: GV OF POOLER
  • Address: 1000 TOWNE CENTER BLVD
    BUILDING 400
    POOLER, GA
    ZIP 31322
  • Phone: (912) 662-0223

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NPI Details

GENESIS VASCULAR OF POOLER, LLC is an interventional cardiology internal medicine in Pooler, GA. The provider is an area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. GENESIS VASCULAR OF POOLER, LLC NPI is 1376930339. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Gv Of Pooler.

The provider's business location address is:

1000 TOWNE CENTER BLVD
BUILDING 400
POOLER, GA
ZIP 31322-052
Phone: (912) 662-0223
Fax: (912) 662-0224

The provider's authorized official is James Thomas O'dare .
The authorized official title is Principal and has the following contact phone number (856) 335-5025.

The enumeration date for this NPI number is 4/16/2015 and was last updated on 11/13/2015.

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
1207RC0000XInternal MedicineCardiovascular DiseaseNo
22085R0204XRadiologyVascular & Interventional RadiologyNo
32086S0129XSurgeryVascular SurgeryNo
4207RI0011XInternal MedicineInterventional CardiologyYes

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: 3/30/2025

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