Healthcare Provider Details

I. General information

NPI: 1740960434
Provider Name (Legal Business Name): HEART AND VASCULAR CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2023
Last Update Date: 07/19/2023
Certification Date: 04/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 GREENFIELD DR STE 260
CUMMING GA
30040-2824
US

IV. Provider business mailing address

3970 DEPUTY BILL CANTRELL MEM
CUMMING GA
30040-3069
US

V. Phone/Fax

Practice location:
  • Phone: 678-513-2273
  • Fax: 678-513-8869
Mailing address:
  • Phone: 678-513-2273
  • Fax: 678-513-8869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC3500X
TaxonomyCardiac Rehabilitation Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: LARAMI OLIVER
Title or Position: RCM DIRECTOR
Credential:
Phone: 678-513-2273