GRADY PRIMARY CARE L.L.C. NPI 1477716769

NPI Information

NPI: 1477716769
Provider Name: GRADY PRIMARY CARE, L.L.C.
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

CLIA Number: 11D2191876

Address:
235 1ST AVE NE
CAIRO, GA
ZIP 39828
Phone: (229) 378-2214
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GRADY PRIMARY CARE, L.L.C. is a health service clinic center in Cairo, GA. GRADY PRIMARY CARE, L.L.C. NPI is 1477716769. The provider is registered as an organization entity type.

The provider's business location address is:

235 1ST AVE NE
CAIRO, GA
ZIP 39828-118
Phone: (229) 378-2214
Fax: (229) 378-2250

The provider's authorized official is Andrew Allison Dekle .
The authorized official title is Owner and has the following contact phone number (229) 378-2214.

The CLIA number assigned to this NPI record is 11D2191876 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/7/2008 and was last updated on 2/12/2016.

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	261QH0100X	Clinic/Center	Health Service	19509	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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