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General NPI Number Information
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NPI Number | 1104246271
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Entity Type | Organization
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Legal Business Name | HEART ATTACK AND STROKE PREVENTION CENTER OF NEW ALBANY, LLC
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Dates
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Enumeration Date | 04/16/2014
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Last Update Date | 04/16/2014
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Provider Practice Location Address
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Address Line | 226 STARLYN AVE
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City | NEW ALBANY
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State | MS
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Zip | 38652-2428
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Country | US
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Telephone | 404-852-7910
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Fax |
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Provider Business Mailing Address
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Address Line | 1230 PEACHTREE ST NE 19TH FLOOR
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City | ATLANTA
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State | GA
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Zip | 30309-3574
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Country | US
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Telephone | 404-852-7910
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. RAY GREGORY SKINNER
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Credential |
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Telephone | 404-852-7910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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