Midtown Vascular Center
LBN: Physician Consultants Of Georgia Interventional Llc
Midtown Vascular Center is an health care organization with primary practice located at 1445 Georgia Ave Suite 1, Macon GA 31201-7610. The organization recently has 3 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Ambulatory Surgical, Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment, Ambulatory Health Care Facilities / Medical Specialty. Ambulatory Health Care Facilities / Medical Specialty is the primary health care specialty.
Physician Consultants Of Georgia Interventional Llc can be contacted via phone (478) 250-1328, or through Ellis, Reuben Kris via phone (478) 250-1328.
Contact Information
Primary practice address
1445 Georgia Ave Suite 1
Macon GA 31201-7610
Phone: (478) 250-1328
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Ambulatory Surgical | 261QA1903X | 055819 | Georgia |
| Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment | 261QE0700X | 055819 | Georgia |
| Ambulatory Health Care Facilities / Medical Specialty | 261QM2500X | 055819 | Georgia |
Profile Details
| NPI number | 1316389836 |
|---|---|
| LBN Legal business name | Physician Consultants Of Georgia Interventional Llc |
| DBA Doing business as | Midtown Vascular Center |
| Authorized official | Ellis, Reuben Kris M.D., FASN |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 25th, 2013 |
| Last updated | Nov 19th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316389836 | NPPES |
| Georgia | MEDICAID | 003124971A |
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