Healthcare Provider Details

I. General information

NPI: 1851680854
Provider Name (Legal Business Name): CIRRUS ALLIED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2011
Last Update Date: 03/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 NORTHWOODS PKWY, SUITE 105
NORWOOD GA
30071
US

IV. Provider business mailing address

3000 NORTHWOODS PKWY, SUITE 105
NORWOOD GA
30821
US

V. Phone/Fax

Practice location:
  • Phone: 678-993-2290
  • Fax:
Mailing address:
  • Phone: 678-993-2290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Y00000X
TaxonomyHealth Information Specialist/Technologist
License Number0000002578
License Number StateTN

VIII. Authorized Official

Name: MR. TOM HIDOCK
Title or Position: SENIOR RECRUITER
Credential:
Phone: 678-993-2290