<Unavail>

LBN: Physician Diagnostic Services Llc
<Unavail> is an health care organization with primary practice located at 2425 Wall St Se , Conyers GA 30013-6342. The organization recently has 2 registered licenses in different health care specialties including Laboratories / Physiological Laboratory, Suppliers / Durable Medical Equipment & Medical Supplies. Laboratories / Physiological Laboratory is the primary health care specialty. Physician Diagnostic Services Llc can be contacted via phone (678) 487-1266, or through Nauful, Angela Marie via phone (678) 487-1266.

Contact Information

Primary practice address
2425 Wall St Se Conyers GA 30013-6342
Phone: (678) 487-1266
Fax: (240) 371-8541
Website:
Map and Directions
Authorized official contact:
Name: Nauful, Angela Marie
Phone: (678) 487-1266

Health care specialties

SpecialtyCodeLicense #State
Laboratories / Physiological Laboratory 293D00000X
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X

Profile Details

NPI number 1871592501
LBN Legal business name Physician Diagnostic Services Llc
DBA Doing business as <Unavail>
Authorized official Nauful, Angela Marie
Entity Organization
Organization subpart 1 No
Enumeration date Jul 15th, 2005
Last updated Apr 29th, 2008 - about 18 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 1871592501 NPPES
Minnesota MEDICAID 019144200

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