ROMULUS PRIMARY CARE SERVICES LLC NPI 1972056380

NPI Information

  • NPI: 1972056380
  • Provider Name: ROMULUS PRIMARY CARE SERVICES LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 11D2208380
  • Address: 4439 AUSTELL RD
    AUSTELL, GA
    ZIP 30106
  • Phone: (770) 675-7407

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NPI Details

ROMULUS PRIMARY CARE SERVICES LLC is a family medicine in Austell, GA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. ROMULUS PRIMARY CARE SERVICES LLC NPI is 1972056380. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4439 AUSTELL RD
AUSTELL, GA
ZIP 30106-839
Phone: (770) 675-7407
Fax: (770) 693-5922

The provider's authorized official is Shawntrel Monique Watts .
The authorized official title is Credentialing Manager and has the following contact phone number (770) 679-5812.

The CLIA number assigned to this NPI record is 11D2208380 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/2/2016 and was last updated on 7/11/2024.

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
1207Q00000XFamily MedicineYes

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
1003145276CMEDICAIDGEORGIA

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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