Heritage Medical House Call

LBN: Heritage Medical House Call
Heritage Medical House Call is an health care organization with primary practice located at 925 Main Street Suite 300-13, Stone Mountain GA 30083-3098. The organization recently has only one registered license in Agencies / Home Health, which is considered as the primary health care specialty. Heritage Medical House Call can be contacted via phone (888) 461-9765, or through Lane, Kevin Alexander via phone (888) 461-9765.

Contact Information

Primary practice address
925 Main Street Suite 300-13 Stone Mountain GA 30083-3098
Phone: (888) 461-9765
Fax: (678) 381-1684
Website:
Map and Directions
Authorized official contact:
Name: Lane, Kevin Alexander Physician Assistant (PA)
Phone: (888) 461-9765

Health care specialties

SpecialtyCodeLicense #State
Agencies / Home Health 251E00000X 12018049 Georgia

Profile Details

NPI number 1063778983
LBN Legal business name Heritage Medical House Call
DBA Doing business as
Authorized official Lane, Kevin Alexander Physician Assistant (PA)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 4th, 2012
Last updated Oct 31st, 2012 - about 14 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 1063778983 NPPES
Georgia MEDICAID 003124376A

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