Immune Recovery Foundation Llc

LBN: Immune Recovery Foundation Llc
Immune Recovery Foundation Llc is an health care organization with primary practice located at 4646 N Shallowford Rd Suite 200, Atlanta GA 30338-6304. The organization recently has only one registered license in Managed Care Organizations / Exclusive Provider Organization, which is considered as the primary health care specialty. Immune Recovery Foundation Llc can be contacted via phone (770) 455-6100, or through Bradford, S. Edward via phone (770) 455-6100.

Contact Information

Primary practice address
4646 N Shallowford Rd Suite 200 Atlanta GA 30338-6304
Phone: (770) 455-6100
Fax: (727) 455-1999
Website:
Map and Directions
Authorized official contact:
Name: Bradford, S. Edward Physician Assistant (PA)
Phone: (770) 455-6100

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Exclusive Provider Organization 302F00000X

Profile Details

NPI number 1831128578
LBN Legal business name Immune Recovery Foundation Llc
DBA Doing business as
Authorized official Bradford, S. Edward Physician Assistant (PA)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 3rd, 2006
Last updated Aug 22nd, 2020 - about 4 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.

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