Northwest Georgia Oncology Centers, Pc

LBN: Northwest Georgia Oncology Centers, Pc
Northwest Georgia Oncology Centers, Pc is an health care organization with primary practice located at 340 Kennestone Hospital Blvd Suite 200, Marietta GA 30060-1121. The organization recently has 4 registered licenses in different health care specialties including Other Service Providers / Specialist, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Specialty Pharmacy. Other Service Providers / Specialist is the primary health care specialty. Northwest Georgia Oncology Centers, Pc can be contacted via phone (770) 281-5100, or through Gould, Bruce J via phone (770) 281-5100.

Contact Information

Primary practice address
340 Kennestone Hospital Blvd Suite 200 Marietta GA 30060-1121
Fax: (678) 581-7100
Website:
Authorized official contact:
Name: Gould, Bruce J Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 032740 Georgia
Suppliers / Pharmacy 333600000X Georgia
Suppliers / Community/Retail Pharmacy 3336C0003X Georgia
Suppliers / Specialty Pharmacy 3336S0011X Georgia

Profile Details

NPI number 1750376695
LBN Legal business name Northwest Georgia Oncology Centers, Pc
DBA Doing business as
Authorized official Gould, Bruce J Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 16th, 2005
Last updated Jun 1st, 2011 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750376695 NPPES
Georgia MEDICAID 300028463A
Georgia Other GRP245

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