Provider Type Icon

ELLIJAY URGENT CARE & FAMILY PRACTICE LLC NPI 1700237633


NPI Information

NPI: 1700237633
Provider Name: ELLIJAY URGENT CARE & FAMILY PRACTICE LLC

Doing Business As: ELLIJAY URGENT CARE & FAMILY PRACTICE

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

CLIA Number: 11D2115096

Address:
97 HEFNER ST STE 202
EAST ELLIJAY, GA
ZIP 30540
Phone: (706) 635-5177
Get Directions

ELLIJAY URGENT CARE & FAMILY PRACTICE LLC is a rural health clinic center in East Ellijay, GA. ELLIJAY URGENT CARE & FAMILY PRACTICE LLC NPI is 1700237633. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Ellijay Urgent Care & Family Practice.

The provider's business location address is:

97 HEFNER ST STE 202
EAST ELLIJAY, GA
ZIP 30540-268
Phone: (706) 635-5177
Fax: (706) 635-2274

The provider's authorized official is Ellijay Urgent Care Family Practice. .
The authorized official title is Owner and has the following contact phone number (706) 635-5177.

The CLIA number assigned to this NPI record is 11D2115096 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/22/2016 and was last updated on 10/1/2018.


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 Medicine062579GEORGIANo
2261QR1300XClinic/CenterRural HealthYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.