<Unavail>
LBN: Northside Children'S Pediatric Center, Llc
<Unavail> is an health care organization with primary practice located at 391 East Main Street Historic Hawkins Building, Canton GA 30114-2712. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Ambulatory Health Care Facilities / Primary Care. Allopathic & Osteopathic Physicians / Pediatrics is the primary health care specialty.
Northside Children'S Pediatric Center, Llc can be contacted via phone (770) 720-6963, or through Anderson, Stephanie Heaton via phone (770) 720-6963.
Contact Information
Primary practice address
391 East Main Street Historic Hawkins Building
Canton GA 30114-2712
Phone: (770) 720-6963
Fax: (770) 720-6965
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | GA 54532 | Georgia |
| Ambulatory Health Care Facilities / Primary Care | 261QP2300X | GA PHYSICIAN 54532 | Georgia |
Profile Details
| NPI number | 1396945515 |
|---|---|
| LBN Legal business name | Northside Children'S Pediatric Center, Llc |
| DBA Doing business as | <Unavail> |
| Authorized official | Anderson, Stephanie Heaton DNP, PNP, RNC |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 25th, 2007 |
| Last updated | Jan 24th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396945515 | NPPES |
| Georgia | MEDICAID | 629697125A | |
| Georgia | Other | 1396945515 |
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