<Unavail>

LBN: The Longstreet Clinic, Pc
<Unavail> is an health care organization with primary practice located at 725 Jesse Jewell Pkwy Se Suite 260, Gainesville GA 30501-3834. The organization recently has only one registered license in Laboratories / Clinical Medical Laboratory, which is considered as the primary health care specialty. The Longstreet Clinic, Pc can be contacted via phone (770) 535-0079, or through Collins, Amelia L. via phone (770) 718-1122.

Contact Information

Primary practice address
725 Jesse Jewell Pkwy Se Suite 260 Gainesville GA 30501-3834
Phone: (770) 535-0079
Fax: (770) 297-6610
Website:
Map and Directions
Authorized official contact:
Name: Collins, Amelia L.
Phone: (770) 718-1122

Health care specialties

SpecialtyCodeLicense #State
Laboratories / Clinical Medical Laboratory 291U00000X 069-004 Georgia

Profile Details

NPI number 1003052416
LBN Legal business name The Longstreet Clinic, Pc
DBA Doing business as <Unavail>
Authorized official Collins, Amelia L.
Entity Organization
Organization subpart 1 Yes
Enumeration date Jan 7th, 2009
Last updated Jan 7th, 2009 - about 17 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 1003052416 NPPES
Georgia MEDICAID 000679764A

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