Organization Name: | NORTHWEST GEORGIA ONCOLOGY CENTERS, PC |
NPI Number: | 1083742175 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRUCE J GOULD (MD PHYSICIAN) |
Mailing Address: | 100 Market Place Blvd Ste 200 Cartersville |
State: | GA US |
Postal Code: | 301218718 |
Phone Number: | 7703867253 |
Fax Number: | 7703826424 |
NPI Enumeration Date: | 03/01/2007 |
NPI Last Update Date: | 12/01/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 0741780004 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |