Promedica Psychiatry Group

LBN: Promedica, Inc.
Promedica Psychiatry Group is an health care organization with primary practice located at 2430 Tucker Dr Bldg A, Loganville GA 30052-4390. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as the primary health care specialty. Promedica, Inc. can be contacted via phone (770) 554-8812, or through Littrell, Kimberly H. via phone (770) 554-8812.

Contact Information

Primary practice address
2430 Tucker Dr Bldg A Loganville GA 30052-4390
Phone: (770) 554-8812
Fax: (770) 554-9810
Website:
Map and Directions
Authorized official contact:
Name: Littrell, Kimberly H. MS, APRN, BC
Phone: (770) 554-8812

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 029689 Georgia

Profile Details

NPI number 1922036508
LBN Legal business name Promedica, Inc.
DBA Doing business as Promedica Psychiatry Group
Authorized official Littrell, Kimberly H. MS, APRN, BC
Entity Organization
Organization subpart 1 No
Enumeration date Jun 30th, 2006
Last updated Apr 28th, 2008 - about 17 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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Identifiers

StateTypeNumberIssuer
All States NPI 1922036508 NPPES
Georgia MEDICAID 00345408A

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