Healthcare Provider Details
I. General information
NPI: 1437816709
Provider Name (Legal Business Name): 818 DIAGNOSTIC SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/22/2021
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1900 LEDO RD STE A
ALBANY GA
31707-1813
US
IV. Provider business mailing address
2800 OLD DAWSON ROAD SUITE2 #275
ALBANY GA
31707
US
V. Phone/Fax
- Phone: 229-789-3229
- Fax: 229-329-4231
- Phone: 229-302-8241
- Fax: 762-266-1030
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 246RM2200X |
| Taxonomy | Medical Laboratory Technician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 252Y00000X |
| Taxonomy | Early Intervention Provider Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QC1500X |
| Taxonomy | Community Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NICHELLE
LOUD
Title or Position: OWNER
Credential:
Phone: 229-789-3229