Georgia Immunization Center & Community Services Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

GEORGIA IMMUNIZATION CENTER & COMMUNITY SERVICES INC

Practice address

6721 Springdale Dr Ste a
Riverdale, GA 30274-2455

Phone

(770) 907-9571

NPI assigned

Jan 13, 2021

Organization subpart

No

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

Authorized official

Name

Herbert Perkins

Title

Ceo

Phone

(770) 907-9571

Specialties & licenses 1

Addresses

Other names 1

• Georgia Immunization Center Doing business as

Locations

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

{
    "created_epoch": "1610496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610496000000",
    "number": "1972192144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6721 SPRINGDALE DR STE A",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742455",
            "telephone_number": "770-907-9571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6721 SPRINGDALE DR STE A",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742455",
            "telephone_number": "770-907-9571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA IMMUNIZATION CENTER & COMMUNITY SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-13",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A",
        "authorized_official_last_name": "PERKINS",
        "authorized_official_first_name": "HERBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-907-9571"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Georgia Immunization Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Behavioral Health Agency in Riverdale, GA
• Providers in Riverdale, GA by specialty
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; 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.