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General NPI Number Information
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NPI Number | 1871729343
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE HEALTH PARTNERSHIPS
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Dates
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Enumeration Date | 06/10/2009
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Last Update Date | 06/10/2009
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Provider Practice Location Address
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Address Line | 4040 CHAPEL HILL RD STE Q
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-2763
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Country | US
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Telephone | 678-715-9154
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Fax | 678-715-9159
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Provider Business Mailing Address
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Address Line | 4040 CHAPEL HILL RD STE Q
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-2763
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Country | US
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Telephone | 678-715-9154
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Fax | 678-715-9159
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. WILLIAM Z. RAMIREZ
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Credential | M.D.
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Telephone | 678-715-9154
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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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