Prestige Medcare

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PRESTIGE MEDCARE

Practice address

13 Peach St
Butler, GA 31006-5338

Phone

(478) 391-3220

NPI assigned

Jun 28, 2023

Last updated

Jun 28, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lena Shields

Title

Owner

Phone

(478) 391-3220

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687910400000",
    "number": "1184301533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 PEACH ST",
            "city": "BUTLER",
            "state": "GA",
            "postal_code": "310065338",
            "telephone_number": "478-391-3220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 PEACH ST",
            "city": "BUTLER",
            "state": "GA",
            "postal_code": "310065338",
            "telephone_number": "478-391-3220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE MEDCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-28",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A",
        "authorized_official_last_name": "SHIELDS",
        "authorized_official_first_name": "LENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-391-3220"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Butler, GA
• Providers in Butler, GA by specialty
• Clinical Medical Laboratory in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.