MEDICARE: ATHENS REGIONAL PHYSICIANS SERVICES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282N00000X	General Acute Care Hospital		GA

General Provider Information

NPI Number	:	1124344973
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATHENS REGIONAL PHYSICIANS SERVICES, INC

Provider Business Mailing Address
First Line	:	1270 PRINCE AVE STE 301
Second Line	:
City	:	ATHENS
State	:	GA
Zip	:	30606-2783
Country	:	US
Telephone Number	:	706-475-4917
Fax Number	:

Provider Business Practice Location Address
First Line	:	1270 PRINCE AVE STE 301
Second Line	:
City	:	ATHENS
State	:	GA
Zip	:	30606-2783
Country	:	US
Telephone Number	:	706-475-4917
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF BILLING
Name	:	JIM VOGT
Credential	:
Telephone Number	:	706-475-4917

Provider Enumeration Date	:	04/19/2010
Last Update Date	:	04/19/2010

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