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GEORGIA HEART SPECIALISTS LLC NPI 1467449926


NPI Information

NPI: 1467449926
Provider Name: GEORGIA HEART SPECIALISTS, LLC
Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 11D1036377

Address:
4140 TATE ST NE
COVINGTON, GA
ZIP 30014
Phone: (770) 786-0077
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GEORGIA HEART SPECIALISTS, LLC is a specialist in Covington, GA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. GEORGIA HEART SPECIALISTS, LLC NPI is 1467449926. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4140 TATE ST NE
COVINGTON, GA
ZIP 30014-562
Phone: (770) 786-0077
Fax: (770) 786-8750

The provider's authorized official is Bridget Hummel .
The authorized official title is Office Manager and has the following contact phone number (770) 786-0077.

The CLIA number assigned to this NPI record is 11D1036377 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/30/2005 and was last updated on 3/26/2015.


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
1174400000XSpecialistYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1GRP3382MEDICARE PINGEORGIA
200408614FMEDICAIDGEORGIA
3E61391MEDICARE UPINGEORGIA

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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