Gorantla Govindaiah, M.D., S.C.
LBN: Gorantla Govindaiah, M.D., S.C.
Gorantla Govindaiah, M.D., S.C. is an health care organization with primary practice located at 4366 Kennedy Dr Suite B, East Moline IL 61244-4288. The organization recently has only one registered license in Ambulatory Health Care Facilities / Health Service, which is considered as the primary health care specialty.
Gorantla Govindaiah, M.D., S.C. can be contacted via phone (309) 796-1510, or through Govindaiah, Gorantla via phone (309) 796-1510.
Contact Information
Primary practice address
4366 Kennedy Dr Suite B
East Moline IL 61244-4288
Phone: (309) 796-1510
Fax: (309) 796-1565
Website:
Authorized official contact:
Name: Govindaiah, Gorantla Doctor of Medicine (MD)
Phone: (309) 796-1510
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Health Service | 261QH0100X |
Profile Details
| NPI number | 1023222502 |
|---|---|
| LBN Legal business name | Gorantla Govindaiah, M.D., S.C. |
| DBA Doing business as | |
| Authorized official | Govindaiah, Gorantla Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 10th, 2007 |
| Last updated | May 15th, 2008 - about 16 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023222502 | NPPES |
| Illinois | Other | 263500 | MEDICARE GROUP |
| Illinois | Other | 8100279 | MEDICARE GROUP |
| Illinois | MEDICAID | 036049003 | MEDICARE GROUP |
| Illinois | Other | K44585 | MEDICARE GROUP |
| Illinois | Other | 010063712 | MEDICARE GROUP |
| Illinois | Other | 98669 | MEDICARE GROUP |
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