Lawrence Joel Army Health Clinic in Atlanta - Military Outpatient Operational (transportable) Component
Lawrence Joel Army Health Clinic - NPI 1265516470
Lawrence Joel Army Health Clinic is a Military Outpatient Operational (transportable) Component in Atlanta, Georgia. Lawrence Joel Army Health Clinic practices all healthcare services and medical treatments related to Military Outpatient Operational (transportable) Component. The NPI Number for Lawrence Joel Army Health Clinic is 1265516470. The last update date is 2020-08-22.
Lawrence Joel Army Health Clinic's current location address is 2156 Spink St Nw, Atlanta, Georgia. You can contact this provider via phone number 4047925919. The mailing address for Lawrence Joel Army Health Clinic is 2156 Spink St Nw, Atlanta, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Lawrence Joel Army Health Clinic |
|---|---|
| Address | 2156 Spink St Nw, Atlanta, Georgia |
| Phone Number | 4047925919 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | STAFF PHAR |
|---|---|
| Authorized Official Name | Agnew Rakestraw Carmen |
| Credentials | RPH |
| Telephone Number | 4044640304 |
NPI Number Detail
| NPI Number | 1265516470 |
|---|---|
| Provider Enumeration Date | 2006-10-24 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 2156 Spink St Nw |
|---|---|
| City | Atlanta |
| State | Georgia (GA) |
| Post Code | 303181154 |
| Phone Number | 4047925919 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Military Outpatient Operational (transportable) Component |
|---|---|
| Taxonomy | 261Qm1102X |
| Licence No | 11620 |
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Definition: Non-fixed facilities or distinct parts of a "non-fixed" facility, providing outpatient medical and dental services, primarily intended for DoD active duty. The entity is funded with other than Defense Health Program funding. Non-DoD active duty may r |
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What is the unique provider identifier assigned to Lawrence Joel Army Health Clinic?
The Lawrence Joel Army Health Clinic has been issued the NPI (National Provider Identifier) 1265516470 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Can you provide the Lawrence Joel Army Health Clinic's physical address?
The Lawrence Joel Army Health Clinic is physically located at 2156 Spink St Nw, in the city of Atlanta, GA, with the postal code 303181154.
What is the Lawrence Joel Army Health Clinic's area of specialization and corresponding taxonomy classification?
The Lawrence Joel Army Health Clinic's specialty field is Military Outpatient Operational (transportable) Component, and it falls under the taxonomy code 261Qm1102X, which categorizes healthcare providers based on their specialties.
On what date did the Lawrence Joel Army Health Clinic receive its 1265516470 assignment from the Centers for Medicare & Medicaid Services?
The Lawrence Joel Army Health Clinic was assigned its 1265516470 by the Centers for Medicare & Medicaid Services on 2006-10-24.
When was the Lawrence Joel Army Health Clinic's information last updated?
The Lawrence Joel Army Health Clinic's information was last updated on 2020-08-22.