Healthcare Provider Details
I. General information
NPI: 1518935337
Provider Name (Legal Business Name): HMP DIAGNOSTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/09/2006
Last Update Date: 05/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
205 CLEVELAND RD SUITE B
BOGART GA
30622-6821
US
IV. Provider business mailing address
PO BOX 49769
ATHENS GA
30604-0769
US
V. Phone/Fax
- Phone: 706-546-7430
- Fax: 706-546-7434
- Phone: 706-546-7430
- Fax: 706-546-7434
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 293D00000X |
| Taxonomy | Physiological Laboratory |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ERIC
PARKHILL
Title or Position: VICE-PRESIDENT
Credential: RRT
Phone: 706-546-7430