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GRANT PARK FAMILY HEALTH CENTER INC. NPI 1871669358


NPI Information

NPI: 1871669358
Provider Name: GRANT PARK FAMILY HEALTH CENTER, INC.

Doing Business As: GRANT PARK CLINIC

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 11D0259285

Address:
1340 BOULEVARD SE
ATLANTA, GA
ZIP 30315
Phone: (404) 627-4259
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GRANT PARK FAMILY HEALTH CENTER, INC. is a primary care clinic center in Atlanta, GA. GRANT PARK FAMILY HEALTH CENTER, INC. NPI is 1871669358. The provider is registered as an organization entity type.
The provider Is Doing Business As Grant Park Clinic.

The provider's business location address is:

1340 BOULEVARD SE
ATLANTA, GA
ZIP 30315-016
Phone: (404) 627-4259
Fax: (404) 624-5795

The provider's authorized official is Terry W. Wood .
The authorized official title is Director and has the following contact phone number (404) 627-4259.

The CLIA number assigned to this NPI record is 11D0259285 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 11/28/2006 and was last updated on 8/22/2020.


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
1261QP2300XClinic/CenterPrimary CareYes

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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