Mid Provider Inc is a Gerontology in Roswell, Georgia. Mid Provider Inc practices all healthcare services and medical treatments related to Gerontology. The NPI Number for Mid Provider Inc is 1962621532. The last update date is 2010-01-05.
Mid Provider Inc's current location address is 1230 Worthington Hills Dr, Roswell, Georgia. You can contact this provider via phone number 4042290274 and fax number 7705184026. The mailing address for Mid Provider Inc is 1230 Worthington Hills Dr, Roswell, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Mid Provider Inc |
|---|---|
| Address | 1230 Worthington Hills Dr, Roswell, Georgia |
| Phone Number | 4042290274 |
| Fax Number | 7705184026 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | DIRECTOR |
|---|---|
| Authorized Official Name | Norris J Patricia |
| Credentials | GNP |
| Telephone Number | 4042290274 |
NPI Number Detail
| NPI Number | 1962621532 |
|---|---|
| Provider Enumeration Date | 2007-04-24 |
| Last Updated Date | 2010-01-05 |
Provider Mailing Address Detail
| Address | 1230 Worthington Hills Dr |
|---|---|
| City | Roswell |
| State | Georgia (GA) |
| Post Code | 300761753 |
| Phone Number | 4042290274 |
| Fax Number | 7705184026 |
Provider's Primary Taxonomy Detail
| Speciality | Gerontology |
|---|---|
| Taxonomy | 363Lg0600X |
| Licence No | RN133089 |
|
Definition: An advanced practice registered nurse expert in providing care to older adult patients. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| DD4864 | GA | RAILROAD RETIERMENT |
Post Comment/ Review Below
What is the Mid Provider Inc's 1962621532?
The Mid Provider Inc's NPI (National Provider Identifier) Number is 1962621532. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Mid Provider Inc?
The Mid Provider Inc is situated at 1230 Worthington Hills Dr, in the city of Roswell, state of GA, with the zip code 300761753.
What is Mid Provider Inc's specialized field of practice, and what is the corresponding taxonomy classification code?
The Mid Provider Inc's area of specialization is Gerontology, and the corresponding taxonomy code that categorizes this field of practice is 363Lg0600X.
On what date did the Mid Provider Inc receive its 1962621532 assignment from the Centers for Medicare & Medicaid Services?
The Mid Provider Inc was assigned its 1962621532 by the Centers for Medicare & Medicaid Services on 2007-04-24.
As of what date were the Mid Provider Inc's details last updated?
The information pertaining to the Mid Provider Inc, including its address, specialty, and other details, was most recently updated on 2010-01-05.
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