Healthstat on-Site Clinic/Milliken New Holland
Organization Active NPI Preventive Medicine/Occupational Environmental Medicine Physician · Gainesville, GA
NPI 1114350113 · NPPES record last updated Aug 13, 2013
Key facts
- NPI
- 1114350113
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X
- Legal business name
- HEALTHSTAT ON-SITE CLINIC/MILLIKEN NEW HOLLAND
- Practice address
- 1750 Jesse Jewel Pkwy
Gainesville, GA 30501-2566 - Phone
- (770) 535-8206
- NPI assigned
- Aug 13, 2013
- Organization subpart
- No
Authorized official
- Name
- Warren Hutton
- Title
- Coo
- Phone
- (704) 529-6161
Corporate family (same tax ID) 14
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D1078641 | Healthstat Incorporate on Site Clinic | Certificate of waiver | Jan 13, 2028 |
National Provider Directory
- Tax ID family
- Healthstat on-Site Clinicmilliken Kex
Locations
1750 Jesse Jewell Pkwy SE
Gainesville, GA 30501
Phone (770) 535-8206
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Preventive Medicine/Occupational Environmental Medicine Physician |
2083P0500X | Yes |
Addresses
Primary practice location
1750 Jesse Jewel Pkwy
Gainesville, GA 30501-2566
Mailing address
4651 Charlotte Park Dr
Suite 300
Charlotte, NC 28217-1956
Other providers in Gainesville, GA
- Heather Jane Head
- Stella Jeaneva Head
- Wesley D Head
- Healingstrands Salon & More
- Healthcare Specialty Transactions, LLC
- Healthy Life Counseling
- Samantha Heard
- Teresa Hearn
- Heart Song, LLC
- Heather Tiffany Heath
All providers in Gainesville, GA · Preventive Medicine/Occupational Environmental Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.