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LIFE CARE FAMILY PRACTICE NPI 1386921310


NPI Information

NPI: 1386921310
Provider Name: LIFE CARE FAMILY PRACTICE
Classification: Health Maintenance Organization - 302R00000X
Entity Type: Organization

CLIA Number: 11D0888322

Address:
8464 ADAIR ST
DOUGLASVILLE, GA
ZIP 30134
Phone: (770) 949-9804
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LIFE CARE FAMILY PRACTICE is a health maintenance organization in Douglasville, GA. The provider is (1) A form of health insurance in which its members prepay a premium for the HMO's health services which generally include inpatient and ambulatory care. For the patient, an HMO means reduced out-of-pocket costs (i.e. no deductible), no paperwork (i.e. insurance forms), and only a small copayment for each office visit to cover the paperwork handled by the HMO; (2) A organization of health care personnel and facilities that provides a comprehensive range of health services to an enrolled population for a fixed sum of money paid in advance for a specified period of time. These health services include a wide variety of medical treatments and consults, inpatient and outpatient hospitalization, home health service, ambulance service, and sometimes dental and pharmacy services. The HMO may be organized as a group model, an individual practice association (IPA), a network model or a staff model. LIFE CARE FAMILY PRACTICE NPI is 1386921310. The provider is registered as an organization entity type.

The provider's business location address is:

8464 ADAIR ST
DOUGLASVILLE, GA
ZIP 30134-839
Phone: (770) 949-9804
Fax: (770) 949-9842

The provider's authorized official is Michael Moody .
The authorized official title is Doctor/owner and has the following contact phone number (770) 949-9804.

The CLIA number assigned to this NPI record is 11D0888322 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/4/2011 and was last updated on 11/4/2011.


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
1305R00000XPreferred Provider Organization037626GEORGIANo
2305S00000XPoint of Service037626GEORGIANo
3302R00000XHealth Maintenance Organization037626GEORGIAYes

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
1F73661MEDICARE UPINGEORGIA

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

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