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PMR GEORGIA HOLDING LLC NPI 1013661438


NPI Information

NPI: 1013661438
Provider Name: PMR GEORGIA HOLDING, LLC

Doing Business As: JENCARE SENIOR MEDICAL CENTER HAMMOND PARK

Classification: Non-Pharmacy Dispensing Site - 332900000X
Entity Type: Organization

CLIA Number: 11D2253544

Address:
2720 METROPOLITAN PKWY SW
ATLANTA, GA
ZIP 30315
Phone: (404) 905-9200
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PMR GEORGIA HOLDING, LLC is a non pharmacy dispensing site in Atlanta, GA. The provider is a site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) PMR GEORGIA HOLDING, LLC NPI is 1013661438. The provider is registered as an organization entity type.
The provider Is Doing Business As Jencare Senior Medical Center Hammond Park.

The provider's business location address is:

2720 METROPOLITAN PKWY SW
ATLANTA, GA
ZIP 30315-914
Phone: (404) 905-9200
Fax: (404) 815-4330

The provider's authorized official is Mary Chen .
The authorized official title is Authorized Official and has the following contact phone number (305) 628-6117.

The CLIA number assigned to this NPI record is 11D2253544 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/4/2022 and was last updated on 10/3/2022.


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
1332900000XNon-Pharmacy Dispensing SiteYes

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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