FAMILY PRACTICE OF HABERSHAM PC NPI 1124154794

NPI Information

NPI: 1124154794
Provider Name: FAMILY PRACTICE OF HABERSHAM PC

Former Legal Business Name: HABERSHAM PRIMARY CARE

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
590 HISTORIC HWY 441 N
DEMOREST, GA
ZIP 30535
Phone: (706) 754-5511
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FAMILY PRACTICE OF HABERSHAM PC is a primary care clinic center in Demorest, GA. FAMILY PRACTICE OF HABERSHAM PC NPI is 1124154794. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Habersham Primary Care.

The provider's business location address is:

590 HISTORIC HWY 441 N
DEMOREST, GA
ZIP 30535-779
Phone: (706) 754-5511
Fax: (706) 754-5577

The provider's authorized official is Beverly C Carter .
The authorized official title is Manager and has the following contact phone number (706) 754-1252.

The enumeration date for this NPI number is 2/26/2007 and was last updated on 12/16/2008.

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	261QP2300X	Clinic/Center	Primary Care	032741	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	GRP3078	OTHER	GEORGIA	MEDICARE GRP #

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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