Carrollton Orthopaedic Clinic PC
Organization Active NPI Pharmacy · Bremen, GA
NPI 1013376490 · NPPES record last updated Mar 3, 2016
Key facts
- NPI
- 1013376490
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- 038964 (GA)
- Legal business name
- CARROLLTON ORTHOPAEDIC CLINIC PC
- Practice address
- 204 Allen Memorial Dr Ste 102
Bremen, GA 30110-2063 - Phone
- (727) 755-0679
- NPI assigned
- Feb 15, 2016
- Organization subpart
- No
Authorized official
- Name
- James Gilbert
- Title
- Cfo
- Phone
- (727) 755-0693
Corporate family (same tax ID) 4
National Provider Directory
- Tax ID family
- Carrollton Ortho Clinic
Locations
204 Allen Memorial Dr
Ste 102
Bremen, GA 30110
Phone (727) 755-0679
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1603
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 038964 | GA | Yes |
| Clinic Pharmacy | 3336C0002X |
Addresses
Primary practice location
204 Allen Memorial Dr Ste 102
Bremen, GA 30110-2063
Mailing address
311 Park Place Blvd
Suite 500
Clearwater, FL 33759-4904
Phone (727) 755-0693
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000104427 | Medicaid | GA | |
| 2158424 | Other | PK |
Other names
- Carrollton Orthopaedic Clinic
Other providers in Bremen, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.