Locust Grove Family Medicine in Locust Grove - Non-pharmacy Dispensing Site
Locust Grove Family Medicine - NPI 1629169164
Locust Grove Family Medicine is a Non-pharmacy Dispensing Site in Locust Grove, Georgia. Locust Grove Family Medicine practices all healthcare services and medical treatments related to Non-pharmacy Dispensing Site. The NPI Number for Locust Grove Family Medicine is 1629169164. The last update date is 2016-03-14.
Locust Grove Family Medicine's current location address is 3778 Highway 42, Locust Grove, Georgia. You can contact this provider via phone number 6786106649 and fax number 6786106025. The mailing address for Locust Grove Family Medicine is 3778 Highway 42, Locust Grove, Georgia. To know further, please read the information below!
Provider Profile Detail
Provider Organization | Locust Grove Family Medicine |
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Address | 3778 Highway 42, Locust Grove, Georgia |
Phone Number | 6786106649 |
Fax Number | 6786106025 |
Sole Proprietor | -- |
Credentials | -- |
Authorized Official
Title or Position | OWNER |
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Authorized Official Name | Trivedi J Nimisha |
Credentials | MD |
Telephone Number | 6786106649 |
NPI Number Detail
NPI Number | 1629169164 |
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Provider Enumeration Date | 2006-09-28 |
Last Updated Date | 2016-03-14 |
Provider Mailing Address Detail
Address | 3778 Highway 42 |
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City | Locust Grove |
State | Georgia (GA) |
Post Code | 302483632 |
Phone Number | 6786106649 |
Fax Number | 6786106025 |
Provider's Primary Taxonomy Detail
Speciality | Non-pharmacy Dispensing Site |
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Taxonomy | 332900000X |
Licence No | 53715 |
Definition: A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
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What is the unique provider identifier assigned to Locust Grove Family Medicine?
The Locust Grove Family Medicine has been issued the NPI (National Provider Identifier) 1629169164 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Where is the Locust Grove Family Medicine located?
The Locust Grove Family Medicine is located at 3778 Highway 42, Locust Grove, GA 302483632.
What is Locust Grove Family Medicine's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Locust Grove Family Medicine's specialized field of practice is Non-pharmacy Dispensing Site, and the corresponding taxonomy code that categorizes this area of specialization is 332900000X.
On what date did the Locust Grove Family Medicine receive the assignment of its 1629169164 from the Centers for Medicare & Medicaid Services?
The Locust Grove Family Medicine was issued its 1629169164 by the Centers for Medicare & Medicaid Services on 2006-09-28.
As of what date were the Locust Grove Family Medicine's details last updated?
The information pertaining to the Locust Grove Family Medicine, including its address, specialty, and other details, was most recently updated on 2016-03-14.