1942533435 NPI number — ATHENS LIMESTONE HEALTH SERVICES LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942533435 NPI number — ATHENS LIMESTONE HEALTH SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ATHENS LIMESTONE HEALTH SERVICES LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ATHENS LIMESTONE PEDIATRIC CLINIC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942533435
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/08/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 999
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATHENS
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35612-0999
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-216-9730
Provider Business Mailing Address Fax Number:
256-216-9731

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 FITNESS WAY
Provider Second Line Business Practice Location Address:
SUITE 2100
Provider Business Practice Location Address City Name:
ATHENS
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35611-2480
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-216-9730
Provider Business Practice Location Address Fax Number:
256-216-9731
Provider Enumeration Date:
09/15/2009

Additional Information

Authorized Official

Authorized Official Last Name:
COMER
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
R
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
256-233-9172

Provider Taxonomy Codes

  • Taxonomy code: 208000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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