Organization Name: | LIFELINE MEDICAL CENTER, LLC |
NPI Number: | 1013321702 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SAFIA PIRANI (OWNER/PROVIDER) |
Mailing Address: | 3330 Peachtree Corners Cir Ste H Norcross |
State: | GA US |
Postal Code: | 300923657 |
Phone Number: | 6785800950 |
Fax Number: | 6785800991 |
NPI Enumeration Date: | 06/20/2014 |
NPI Last Update Date: | 06/20/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | 056624 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |