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MEDMARK TREATMENT CENTERS OF GEORGIA INC NPI 1316186968


NPI Information

NPI: 1316186968
Provider Name: MEDMARK TREATMENT CENTERS OF GEORGIA, INC

Doing Business As: MEDMARK TREATMENT CENTERS BLAIRSVILLE

Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

CLIA Number: 11D2014841

Address:
20 COMMERCE DR
BLAIRSVILLE, GA
ZIP 30512
Phone: (706) 781-6987
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MEDMARK TREATMENT CENTERS OF GEORGIA, INC is a rehabilitation and substance use disorder clinic center in Blairsville, GA. MEDMARK TREATMENT CENTERS OF GEORGIA, INC NPI is 1316186968. The provider is registered as an organization entity type.
The provider Is Doing Business As Medmark Treatment Centers Blairsville.

The provider's business location address is:

20 COMMERCE DR
BLAIRSVILLE, GA
ZIP 30512-913
Phone: (706) 781-6987
Fax: (706) 781-3026

The provider's authorized official is Michael Saul .
The authorized official title is Vp and has the following contact phone number (214) 379-3300.

The CLIA number assigned to this NPI record is 11D2014841 - other - narcotic treatment prog with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/5/2009 and was last updated on 2/13/2024.


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
1261QM2800XClinic/CenterMethadoneNo
2261QR0405XClinic/CenterRehabilitation, Substance Use DisorderYes

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
1NTP001040OTHERGEORGIAGEORGIA NTP PERMIT

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.