Hometown Pediatrics Llc

LBN: Hometown Pediatrics Llc
Hometown Pediatrics Llc is an health care organization with primary practice located at 108 N 4Th St , Vienna GA 31092-1115. The organization recently has only one registered license in Ambulatory Health Care Facilities / Medical Specialty, which is considered as the primary health care specialty. Hometown Pediatrics Llc can be contacted via phone (229) 231-5008, or through Pullen, Haley Ellis via phone (850) 688-0943.

Contact Information

Primary practice address
108 N 4Th St Vienna GA 31092-1115
Phone: (229) 231-5008
Fax: (229) 231-5539
Website:
Map and Directions
Authorized official contact:
Name: Pullen, Haley Ellis Family Nurse Practitioner (FNP)
Phone: (850) 688-0943

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Medical Specialty 261QM2500X

Profile Details

NPI number 1013623263
LBN Legal business name Hometown Pediatrics Llc
DBA Doing business as
Authorized official Pullen, Haley Ellis Family Nurse Practitioner (FNP)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 30th, 2023
Last updated Jan 30th, 2023 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013623263 NPPES
Georgia MEDICAID 1932748894

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