GRACE MEDICAL ENTREPRISES NPI 1982216503

NPI Information

NPI: 1982216503
Provider Name: GRACE MEDICAL ENTREPRISES
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
2385 WALL ST SE STE 204-A
CONYERS, GA
ZIP 30013
Phone: (470) 275-3926
Get Directions

GRACE MEDICAL ENTREPRISES is a multi-specialty clinic center in Conyers, GA. GRACE MEDICAL ENTREPRISES NPI is 1982216503. The provider is registered as an organization entity type.

The provider's business location address is:

2385 WALL ST SE STE 204-A
CONYERS, GA
ZIP 30013-187
Phone: (470) 275-3926

The provider's authorized official is Tameka Duncan .
The authorized official title is Owner and has the following contact phone number (678) 590-1170.

The enumeration date for this NPI number is 8/17/2020 and was last updated on 3/6/2023.

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	251S00000X	Community/Behavioral Health		No
2	261QC1500X	Clinic/Center	Community Health	No
3	101Y00000X	Counselor		No
4	177F00000X	Lodging		No
5	251B00000X	Case Management		No
6	261QH0100X	Clinic/Center	Health Service	No
7	261QS1000X	Clinic/Center	Student Health	No
8	291U00000X	Clinical Medical Laboratory		No
9	305R00000X	Preferred Provider Organization		No
10	343900000X	Non-emergency Medical Transport (VAN)		No
11	3747P1801X	Technician	Personal Care Attendant	No
12	261QM1300X	Clinic/Center	Multi-Specialty	Yes

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
1	365411	OTHER	FLORIDA	MULTI-SPECIALTY FACILITY
2	1982216503	OTHER	GEORGIA	COMMERCIAL

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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