Healthcare Provider Details

I. General information

NPI: 1255747077
Provider Name (Legal Business Name): SFH COLUMBUS CARDIOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2014
Last Update Date: 04/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 MANCHESTER EXPY STE 2001
COLUMBUS GA
31904-6877
US

IV. Provider business mailing address

PO BOX 9006
COLUMBUS GA
31908-9006
US

V. Phone/Fax

Practice location:
  • Phone: 706-323-5552
  • Fax: 706-324-5695
Mailing address:
  • Phone: 706-323-5552
  • Fax: 706-324-5695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: GREG S. HEMBREE
Title or Position: CFO/SVP
Credential:
Phone: 706-320-3751