1558596288 NPI number — SOUTH FULTON REGIONAL MEDICAL CENTER PRO FEE BILLING, LLC

Table of content: MR. ROBERT LEE SCHLEGEL LSW (NPI 1104911858)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558596288 NPI number — SOUTH FULTON REGIONAL MEDICAL CENTER PRO FEE BILLING, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTH FULTON REGIONAL MEDICAL CENTER PRO FEE BILLING, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
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Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
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NPI Number Information

NPI Number:
1558596288
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/23/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
680 ANDERSEN DR
Provider Second Line Business Mailing Address:
FOSTER PLAZA 10
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15220-2759
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-466-1320
Provider Business Mailing Address Fax Number:
404-466-1360

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1170 CLEVELAND AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST POINT
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30344-3615
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-466-1320
Provider Business Practice Location Address Fax Number:
404-466-1360
Provider Enumeration Date:
05/26/2009

Additional Information

Authorized Official

Authorized Official Last Name:
JAMES
Authorized Official First Name:
WESLEY
Authorized Official Middle Name:
O.
Authorized Official Title or Position:
REGIONAL CFO, TENET
Authorized Official Telephone Number:
404-265-5009

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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