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General NPI Number Information
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NPI Number | 1598330714
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Entity Type | Organization
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Legal Business Name | NORTHWEST GEORGIA HEALTHCARE MANAGEMENT LLC
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Dates
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Enumeration Date | 05/20/2021
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Last Update Date | 05/20/2021
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Provider Practice Location Address
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Address Line | 189 PROFESSIONAL CT SE STE 400
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City | CALHOUN
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State | GA
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Zip | 30701-7056
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Country | US
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Telephone | 470-221-0216
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Fax | 404-393-5586
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Provider Business Mailing Address
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Address Line | 2950 CHEROKEE ST NW STE 900
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City | KENNESAW
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State | GA
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Zip | 30144-6505
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Country | US
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Telephone | 470-221-0216
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Fax | 404-393-5586
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | ANDREW J NALL
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Credential |
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Telephone | 678-672-8470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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