Southern Crescent Medical Center, Llc

LBN: Southern Crescent Medical Center, Llc
Southern Crescent Medical Center, Llc is an health care organization with primary practice located at 3579 Highway 138 Se Ste 103 , Stockbridge GA 30281-4127. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Laboratories / Clinical Medical Laboratory, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty. Southern Crescent Medical Center, Llc can be contacted via phone (770) 629-4374, or through Bryant, Shantel via phone (770) 629-4374.

Contact Information

Primary practice address
3579 Highway 138 Se Ste 103 Stockbridge GA 30281-4127
Phone: (770) 629-4374
Fax: (678) 545-1735
Website:
Map and Directions
Authorized official contact:
Name: Bryant, Shantel
Phone: (770) 629-4374

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X
Laboratories / Clinical Medical Laboratory 291U00000X
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X

Profile Details

NPI number 1578111910
LBN Legal business name Southern Crescent Medical Center, Llc
DBA Doing business as
Authorized official Bryant, Shantel
Entity Organization
Organization subpart 1 No
Enumeration date Aug 29th, 2019
Last updated Jun 21st, 2021 - about 5 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 1578111910 NPPES
Georgia MEDICAID 003227501A

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