PRIME CARE & PATHOLOGY INC NPI 1144977802

NPI Information

NPI: 1144977802
Provider Name: PRIME CARE & PATHOLOGY INC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 11D2298204

Address:
1050 GREEN ST SE
CONYERS, GA
ZIP 30012
Phone: (770) 648-7226
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PRIME CARE & PATHOLOGY INC is a primary care clinic center in Conyers, GA. PRIME CARE & PATHOLOGY INC NPI is 1144977802. The provider is registered as an organization entity type.

The provider's business location address is:

1050 GREEN ST SE
CONYERS, GA
ZIP 30012-406
Phone: (770) 648-7226
Fax: (770) 648-7211

The provider's authorized official is Jackson L Gates .
The authorized official title is Owner and has the following contact phone number (678) 591-6509.

The CLIA number assigned to this NPI record is 11D2298204 - independent with a certificate type of Certificate of Compliance.

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

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
1	261QP2300X	Clinic/Center	Primary Care			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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