BRC MEDHEALTH NPI 1689222747

NPI Information

NPI: 1689222747
Provider Name: BRC MEDHEALTH
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 11D2180808

Address:
962 FOREST GLN
JONESBORO, GA
ZIP 30238
Phone: (770) 231-8568
Get Directions

BRC MEDHEALTH is a primary care clinic center in Jonesboro, GA. BRC MEDHEALTH NPI is 1689222747. The provider is registered as an organization entity type.

The provider's business location address is:

962 FOREST GLN
JONESBORO, GA
ZIP 30238-829
Phone: (770) 231-8568
Fax: (678) 489-2348

The provider's authorized official is Barbara R Clark .
The authorized official title is Nurse Practitioner and has the following contact phone number (770) 231-8568.

The CLIA number assigned to this NPI record is 11D2180808 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/30/2019 and was last updated on 8/30/2019.

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	Primary
1	251E00000X	Home Health		No
2	251F00000X	Home Infusion		No
3	261QM1300X	Clinic/Center	Multi-Specialty	No
4	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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