Organization Name: | THE MEDICAL CENTER OF ELBERTON, LLP |
NPI Number: | 1891863569 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BROOKE S HALL (PRACTICE ADMINISTRATOR) |
Mailing Address: | 109 College Ave Elberton |
State: | GA US |
Postal Code: | 306351705 |
Phone Number: | 7062833315 |
Fax Number: | 7062832159 |
NPI Enumeration Date: | 12/01/2006 |
NPI Last Update Date: | 01/06/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | 11-3958 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |