Healthcare Provider Details

I. General information

NPI: 1124331178
Provider Name (Legal Business Name): NORTH GEORGIA HEALTHCARE TUNNEL HILL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2010
Last Update Date: 07/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 CHATTANOOGA RD
TUNNEL HILL GA
30755-9393
US

IV. Provider business mailing address

PO BOX 729
RINGGOLD GA
30736-0729
US

V. Phone/Fax

Practice location:
  • Phone: 706-935-6442
  • Fax: 706-935-6441
Mailing address:
  • Phone: 706-935-6442
  • Fax: 706-935-6441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MYRA D HUNTER
Title or Position: CEO
Credential:
Phone: 706-935-6442