LIFELINE PRIMARY CARE INC NPI 1639426984

NPI Information

  • NPI: 1639426984
  • Provider Name: LIFELINE PRIMARY CARE, INC
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • CLIA Number: 11D2262640
  • Address: 4025 LAWRENCEVILLE HWY NW STE A
    LILBURN, GA
    ZIP 30047
  • Phone: (770) 559-3501

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NPI Details

LIFELINE PRIMARY CARE, INC is a primary care clinic center in Lilburn, GA. LIFELINE PRIMARY CARE, INC NPI is 1639426984. The provider is registered as an organization entity type.

The provider's business location address is:

4025 LAWRENCEVILLE HWY NW STE A
LILBURN, GA
ZIP 30047-876
Phone: (770) 559-3501
Fax: (770) 696-9078

The provider's authorized official is Aziz A Pirani .
The authorized official title is Owner / Physician and has the following contact phone number (770) 559-3501.

The CLIA number assigned to this NPI record is 11D2262640 - other - clinical research office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/6/2012 and was last updated on 8/8/2024.

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
1261QP2300XClinic/CenterPrimary Care61934GEORGIAYes

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
11790922096OTHERGEORGIANPI

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: 11/21/2025

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