CHILDREN'S MEDICAL CENTER P.A. NPI 1821114000

NPI Information

NPI: 1821114000
Provider Name: CHILDREN'S MEDICAL CENTER, P.A.
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 11D0254146

Address:
1676 MULKEY RD STE C
AUSTELL, GA
ZIP 30106
Phone: (770) 941-5107
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CHILDREN'S MEDICAL CENTER, P.A. is a primary care clinic center in Austell, GA. CHILDREN'S MEDICAL CENTER, P.A. NPI is 1821114000. The provider is registered as an organization entity type.

The provider's business location address is:

1676 MULKEY RD STE C
AUSTELL, GA
ZIP 30106-172
Phone: (770) 941-5107
Fax: (770) 944-1013

The provider's authorized official is Julie Morris .
The authorized official title is Business Manager and has the following contact phone number (770) 941-5107.

The CLIA number assigned to this NPI record is 11D0254146 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/21/2007 and was last updated on 8/22/2020.

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	2005-7681	GEORGIA	Yes

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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