PREVENTIVE MEDICINE & CHELATION THERAPY INC NPI 1710142955

NPI Information

NPI: 1710142955
Provider Name: PREVENTIVE MEDICINE & CHELATION THERAPY INC
Classification: Point of Service - 305S00000X
Entity Type: Organization
Address:
148 COBB PKWY
RINGGOLD, GA
ZIP 30736
Phone: (706) 891-1200
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PREVENTIVE MEDICINE & CHELATION THERAPY INC is a point of service in Ringgold, GA. The provider is this product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. PREVENTIVE MEDICINE & CHELATION THERAPY INC NPI is 1710142955. The provider is registered as an organization entity type.

The provider's business location address is:

148 COBB PKWY
RINGGOLD, GA
ZIP 30736-566
Phone: (706) 891-1200
Fax: (706) 891-1202

The provider's authorized official is Robert A Burkich .
The authorized official title is Director and has the following contact phone number (706) 891-1200.

The enumeration date for this NPI number is 7/28/2008 and was last updated on 11/20/2013.

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	305S00000X	Point of Service		MD046372	GEORGIA	Yes

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
1	511G70685	OTHER		MEDICARE PTAN

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

NPI Synchronization or Removal

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