Tracys Medicine Center

LBN: Tracys Medicine Center
Tracys Medicine Center is an health care organization with primary practice located at 3171 Tucker Norcross Rd , Tucker GA 30084-2124. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy. Suppliers / Pharmacy is the primary health care specialty. Tracys Medicine Center can be contacted via phone (770) 939-1642, or through Tracy, Shannan Lynn via phone (770) 939-1642.

Contact Information

Primary practice address
3171 Tucker Norcross Rd Tucker GA 30084-2124
Phone: (770) 939-1642
Fax: (770) 723-9515
Website:
Map and Directions
Authorized official contact:
Name: Tracy, Shannan Lynn
Phone: (770) 939-1642

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X PHRE005288 Georgia

Profile Details

NPI number 1790772473
LBN Legal business name Tracys Medicine Center
DBA Doing business as
Authorized official Tracy, Shannan Lynn
Entity Organization
Organization subpart 1 No
Enumeration date Sep 29th, 2005
Last updated Apr 25th, 2018 - about 7 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 1790772473 NPPES
Georgia MEDICAID 000422881B

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