Southern Crescent Medical Center, Llc
LBN: Southern Crescent Medical Center, Llc
Southern Crescent Medical Center, Llc is an health care organization with primary practice located at 3579 Highway 138 Se Ste 103 , Stockbridge GA 30281-4127. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Laboratories / Clinical Medical Laboratory, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
Southern Crescent Medical Center, Llc can be contacted via phone (770) 629-4374, or through Bryant, Shantel via phone (770) 629-4374.
Contact Information
Primary practice address
3579 Highway 138 Se Ste 103
Stockbridge GA 30281-4127
Phone: (770) 629-4374
Fax: (678) 545-1735
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ||
Laboratories / Clinical Medical Laboratory | 291U00000X | ||
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X |
Profile Details
NPI number | 1578111910 |
---|---|
LBN Legal business name | Southern Crescent Medical Center, Llc |
DBA Doing business as | |
Authorized official | Bryant, Shantel |
Entity | Organization |
Organization subpart 1 | No |
Enumeration date | Aug 29th, 2019 |
Last updated | Jun 21st, 2021 - about 3 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 | 1578111910 | NPPES |
Georgia | MEDICAID | 003227501A |
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