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General NPI Number Information
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NPI Number | 1255069050
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Entity Type | Organization
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Legal Business Name | BG CLINICAL SERVICES LLC
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Dates
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Enumeration Date | 08/10/2022
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Last Update Date | 08/10/2022
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Provider Practice Location Address
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Address Line | 470 VALLEY ST STE 100
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City | BALL GROUND
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State | GA
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Zip | 30107-4068
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Country | US
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Telephone | 678-364-2230
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Fax | 770-735-8925
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Provider Business Mailing Address
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Address Line | 470 VALLEY ST STE 100
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City | BALL GROUND
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State | GA
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Zip | 30107-4068
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Country | US
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Telephone | 678-364-2230
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Fax | 770-735-8925
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Authorized Official
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Title or Position | OWNER
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Name | JEFF RICHARDSON
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Credential |
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Telephone | 678-364-2230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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