Ga Cell and Tissue Diagnostic Center Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

032934 Issued in GA

Legal business name

GA CELL AND TISSUE DIAGNOSTIC CENTER INC.

Practice address

902 N 7TH St
Cordele, GA 31015-3234

Phone

(229) 276-3342

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Harry Staton Latham, M.D.NPI 1043413271

Title

President

Phone

(229) 273-4956

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Harry S. Latham, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Cordele, GA
  • NPI 1043413271
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327881600000",
    "number": "1821100892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 568",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310100568",
            "telephone_number": "229-273-4956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 N 7TH ST",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310153234",
            "telephone_number": "229-276-3342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GA CELL AND TISSUE DIAGNOSTIC CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2012-01-30",
        "status": "A",
        "authorized_official_last_name": "LATHAM",
        "authorized_official_first_name": "HARRY",
        "authorized_official_middle_name": "STATON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "229-273-4956",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "GA",
            "license": "032934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000532111B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DG5747",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy David Fitzgerald
• Brad N Ford, DMD
• Bradshaw Neil Ford, DMD
• Hailey Leeann Fortescue
• Lewis D. Friedlander, MD
• Anita Garces
• Georgia CVS Pharmacy LLC
• Georgia Dental Associates LLC
• Georgia Real Care, LLC
• Marina Stefania Giordano, M. ED, CF-SLP

• Clinical Medical Laboratory in Cordele, GA
• Providers in Cordele, 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 Jan 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.