Northwest Georgia Oncology Centers, PC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

032740 Issued in GA

Legal business name

NORTHWEST GEORGIA ONCOLOGY CENTERS, PC

Practice address

148 Bill Carruth Pkwy
Suite 260
Hiram, GA 30141-3754

Phone

(678) 363-1940

Fax

(678) 581-7110

NPI assigned

Apr 30, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Bruce J Gould, MD

Title

MD/ Physician Medical Director

Phone

(770) 281-5100

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290556800000",
    "number": "1790951788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 HOSPITAL SOUTH DR",
            "address_2": "SUITE 300",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301066810",
            "telephone_number": "770-944-2830",
            "fax_number": "678-581-7170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 BILL CARRUTH PKWY",
            "address_2": "SUITE 260",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301413754",
            "telephone_number": "678-363-1940",
            "fax_number": "678-581-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST GEORGIA ONCOLOGY CENTERS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-30",
        "last_updated": "2010-11-24",
        "status": "A",
        "authorized_official_last_name": "GOULD",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MD/ PHYSICIAN MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "770-281-5100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": "032740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUPPLIER NPI NUMBER (HIRAM)",
            "identifier": "1790951788",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Hiram, GA
• Providers in Hiram, GA by specialty
• Durable Medical Equipment & Medical Supplies in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2010; 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.