Tanner Boutique
LBN: Tanner Medical Center, Inc.
Tanner Boutique is an health care organization with primary practice located at 157 Clinic Ave Suite 202, Carrollton GA 30117-4454. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Prosthetic/Orthotic Supplier. Suppliers / Durable Medical Equipment & Medical Supplies is the primary health care specialty.
Tanner Medical Center, Inc. can be contacted via phone (770) 836-9697, or through Sherseth, Lee C. via phone (770) 836-9697.
Contact Information
Primary practice address
157 Clinic Ave Suite 202
Carrollton GA 30117-4454
Phone: (770) 836-9697
Fax: (770) 836-9897
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | 004396 | Georgia |
| Suppliers / Prosthetic/Orthotic Supplier | 335E00000X | 004396 | Georgia |
Profile Details
| NPI number | 1104850965 |
|---|---|
| LBN Legal business name | Tanner Medical Center, Inc. |
| DBA Doing business as | Tanner Boutique |
| Authorized official | Sherseth, Lee C. |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Jul 10th, 2006 |
| Last updated | Mar 17th, 2009 - about 15 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 | 1104850965 | NPPES |
| Georgia | MEDICAID | 000001867B | |
| Georgia | MEDICAID | 000001867C |
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