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NPI Code Detail

MEDICARE: GEORGIA HIGHLANDS MEDICAL SERVICES, INC.

MEDICARE: GEORGIA HIGHLANDS MEDICAL SERVICES, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QU0200XUrgent Care Clinic/Center
2261QF0400XFederally Qualified Health Center (FQHC)GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174529192
Entity Type Code : Organization
Provider Name (Legal Business Name) : GEORGIA HIGHLANDS MEDICAL SERVICES, INC.
Provider Business Mailing Address
First Line : PO BOX 307
Second Line :
City : CUMMING
State : GA
Zip : 30028-0307
Country : US
Telephone Number : 770-887-1668
Fax Number : 770-781-9937
Provider Business Practice Location Address
First Line : 260 ELM ST
Second Line :
City : CUMMING
State : GA
Zip : 30040-2467
Country : US
Telephone Number : 770-887-1668
Fax Number : 770-781-9937
Authorized Official
Title or Position : CEO
Name : MR. TODD SHIFFLET
Credential :
Telephone Number : 770-887-1668
Provider Enumeration Date : 06/23/2005
Last Update Date : 07/21/2022

Similar Medicare Providers

1457359168 — MRS. KAREN H PIRKLE RN
Practice Location Address:
260 ELM ST
CUMMING, GA
30040-2467
Practice Phone: 770-887-1668
Practice Fax: 770-781-9937
1053318725 — DR. FERNANDO R. ALVAREZ-BOGNAR M.D.
Practice Location Address:
260 ELM ST
CUMMING, GA
30040-2467
Practice Phone: 770-887-1668
Practice Fax: 770-781-9937
1093713786 — MRS. DEBRA L IRVINE RN
Practice Location Address:
260 ELM ST
CUMMING, GA
30040-2467
Practice Phone: 770-887-1668
Practice Fax: 770-781-9937
1144228842 — MRS. CAROL P LYERLY FNP-C
Practice Location Address:
260 ELM ST
CUMMING, GA
30040-2467
Practice Phone: 770-887-1668
Practice Fax: 770-781-9937
1316945025 — MRS. CATHIE DEROSA RN
Practice Location Address:
260 ELM ST
CUMMING, GA
30040-2467
Practice Phone: 770-887-1668
Practice Fax: 770-781-9937
1154329803 — MR. GERALD A ERICKSON JR. PA-C
Practice Location Address:
260 ELM ST
CUMMING, GA
30040-2467
Practice Phone: 770-887-1668
Practice Fax: 770-781-9937

Directions to “GEORGIA HIGHLANDS MEDICAL SERVICES, INC. ” Practice Location

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