Provident Healthcare Llc

LBN: Provident Healthcare Llc
Provident Healthcare Llc is an health care organization with primary practice located at 3505 Lassiter Falls Dr Ne , Marietta GA 30062-4199. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine. Allopathic & Osteopathic Physicians / Geriatric Medicine is the primary health care specialty. Provident Healthcare Llc can be contacted via phone (414) 916-9031, or through Dinavahi, Lakshman K via phone (678) 390-0120.

Contact Information

Primary practice address
3505 Lassiter Falls Dr Ne Marietta GA 30062-4199
Phone: (414) 916-9031
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Dinavahi, Lakshman K Doctor of Medicine (MD)
Phone: (678) 390-0120

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 07088 Georgia
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 07088 Georgia
Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine 207RH0002X 07088 Georgia

Profile Details

NPI number 1154706075
LBN Legal business name Provident Healthcare Llc
DBA Doing business as
Authorized official Dinavahi, Lakshman K Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 21st, 2015
Last updated Jul 22nd, 2015 - about 9 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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