The Longstreet Clinic Pc
LBN: The Longstreet Clinic Pc
The Longstreet Clinic Pc is an health care organization with primary practice located at 725 Jesse Jewell Pkwy Se Ste 395 , Gainesville GA 30501-3834. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Prosthetic/Orthotic Supplier. Suppliers / Prosthetic/Orthotic Supplier is the primary health care specialty.
The Longstreet Clinic Pc can be contacted via phone (770) 533-6680, or through Collins, Amelia Lowe via phone (770) 718-1122.
Contact Information
Primary practice address
725 Jesse Jewell Pkwy Se Ste 395
Gainesville GA 30501-3834
Phone: (770) 533-6680
Fax: (770) 533-6681
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Prosthetic/Orthotic Supplier | 335E00000X |
Profile Details
| NPI number | 1053422428 |
|---|---|
| LBN Legal business name | The Longstreet Clinic Pc |
| DBA Doing business as | |
| Authorized official | Collins, Amelia Lowe |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Aug 31st, 2006 |
| Last updated | Apr 11th, 2024 - about 7 months 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 | 1053422428 | NPPES |
| Other | 1154222 | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| MEDICAID | 439568713B | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| MEDICAID | 439568713A | NCPDP PROVIDER IDENTIFICATION NUMBER |
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