Stone Mountain Immediate Medical Care, Inc.

LBN: Stone Mountain Immediate Medical Care, Inc.
Stone Mountain Immediate Medical Care, Inc. is an health care organization with primary practice located at 833 N Hairston Rd , Stone Mountain GA 30083-3423. The organization recently has only one registered license in Managed Care Organizations / Health Maintenance Organization, which is considered as the primary health care specialty. Stone Mountain Immediate Medical Care, Inc. can be contacted via phone (770) 879-5553, or through Davis, Doris Lynn via phone (770) 879-5553.

Contact Information

Primary practice address
833 N Hairston Rd Stone Mountain GA 30083-3423
Phone: (770) 879-5553
Fax: (770) 879-5592
Website:
Map and Directions
Authorized official contact:
Name: Davis, Doris Lynn
Phone: (770) 879-5553

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Health Maintenance Organization 302R00000X 038143 Georgia
Managed Care Organizations / Health Maintenance Organization 302R00000X

Profile Details

NPI number 1578569323
LBN Legal business name Stone Mountain Immediate Medical Care, Inc.
DBA Doing business as
Authorized official Davis, Doris Lynn
Entity Organization
Organization subpart 1 No
Enumeration date Jun 27th, 2005
Last updated Nov 20th, 2022 - about 2 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 1578569323 NPPES
Georgia MEDICAID 000703359I

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