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General NPI Number Information
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NPI Number | 1780477893
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Entity Type | Organization
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Legal Business Name | LIFELINE PRIMARY CARE, INC
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Dates
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Enumeration Date | 05/22/2025
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 8095 ROSWELL RD STE A
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City | SANDY SPRINGS
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State | GA
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Zip | 30350-3931
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Country | US
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Telephone | 770-554-8332
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Fax | 678-868-1100
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Provider Business Mailing Address
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Address Line | 4855 RIVER GREEN PKWY STE 700
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City | DULUTH
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State | GA
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Zip | 30096-8337
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Country | US
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Telephone | 770-545-8332
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Fax | 678-868-1100
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Authorized Official
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Title or Position | DIRECTOR
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Name | AZIZ A PIRANI
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Credential | MD
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Telephone | 770-559-3501
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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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