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General NPI Number Information
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NPI Number | 1780120188
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Entity Type | Organization
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Legal Business Name | MOUNTAINTOP HEALTHCARE CO
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Dates
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Enumeration Date | 01/10/2017
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Last Update Date | 06/26/2023
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Provider Practice Location Address
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Address Line | 1976 MAIN ST E STE C
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City | SNELLVILLE
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State | GA
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Zip | 30078-6460
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Country | US
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Telephone | 470-395-3618
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Fax | 770-979-5155
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Provider Business Mailing Address
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Address Line | 3600 DALLAS HWY SW STE 230 PMB 156
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City | MARIETTA
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State | GA
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Zip | 30064-1685
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Country | US
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Telephone | 470-395-3618
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Fax | 770-979-5155
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Authorized Official
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Title or Position | CEO
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Name | BELINDA MILLINGTON
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Credential | MD
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Telephone | 470-395-3618
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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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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 66224
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License Number State | GA
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