Healthcare Provider Details

I. General information

NPI: 1710926241
Provider Name (Legal Business Name): MONROE HMA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 05/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 ALCOVY ST
MONROE GA
30655-2140
US

IV. Provider business mailing address

330 ALCOVY ST
MONROE GA
30655-2140
US

V. Phone/Fax

Practice location:
  • Phone: 770-267-8461
  • Fax:
Mailing address:
  • Phone: 770-267-8461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY PARRY
Title or Position: SR VP AND GENERAL COUNSEL
Credential: ESQ
Phone: 239-598-3176