Center for General Medicine Inc
Organization Active NPI General Practice Physician · Villa Rica, GA
NPI 1184876294 · NPPES record last updated Jul 13, 2010
Key facts
- NPI
- 1184876294
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 17551 (GA)
- Legal business name
- CENTER FOR GENERAL MEDICINE INC
- Practice address
- 809 W. Hwy 78
Suite D
Villa Rica, GA 30180-1520 - Phone
- (770) 456-9996
- Fax
- (770) 456-9949
- NPI assigned
- Oct 21, 2008
- Organization subpart
- No
Authorized official
- Name
- Beth Rollolazo
- Title
- Office Manager
- Phone
- (770) 456-9993
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician |
208D00000X | 17551 | GA | Yes |
Addresses
Primary practice location
809 W. Hwy 78
Suite D
Villa Rica, GA 30180-1520
Mailing address
809 W. Hwy 78
Suite D
Villa Rica, GA 30180-1520
Phone (770) 456-9996
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000113433G | Medicaid | GA | |
| P00425023 | Other | GA | MEDICARE RAILROAD PIN |
| DP5724 | Other | GA | RAILROAD MEDICARE CGM,INC |
| 000114133H | Medicaid | GA |
Other providers in Villa Rica, GA
- William Mason Carroll
- William Thomas Carroll III
- Carrollton Orthopaedic Clinic PC
- Carrollton Orthopaedic Clinic, PC
- Center for Allergy & Asthma of Georgia PC
- Heather A Chambley
- Tara Elizabeth Chaney
- Jamey S. Chang
- Latanya Renee Chapman
- Zeinab Charmchi
All providers in Villa Rica, GA · General Practice 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 Jul 13, 2010. 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.