CHILDRENS HEALTHCARE OF ATLANTA
Nursing Care, Pediatric
Lawrenceville, Georgia
Provider NPI: 1396900247
Organization Information:Organization Name: CHILDRENS HEALTHCARE OF ATLANTA
Practice Location:
494 RISING SUN PATH LAWRENCEVILLE, GA 30043 US
Tel: 770-338-7476 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
494 RISING SUN PATH LAWRENCEVILLE, GA 30043 US
Tel: 770-338-7476 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 3140N1450X | Nursing & Custodial Care Facilities Skilled Nursing Facility Nursing Care, Pediatric | GA | RN158875 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
BLUE CROSS/ BLUE SHIELD | XKH511A63954-01 | GA | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin