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NPI Code Detail

MEDICARE: RIDGEVIEW INSTITUTE,INC

MEDICARE: RIDGEVIEW INSTITUTE,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
1283X00000XRehabilitation Hospital033-304GA
2283Q00000XPsychiatric Hospital033-304GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1100091OTHERGABCBS
258207755001OTHERGACHAMPUS/TRICARE

General Provider Information

NPI Number : 1346242682
Entity Type Code : Organization
Provider Name (Legal Business Name) : RIDGEVIEW INSTITUTE,INC
Provider Business Mailing Address
First Line : 3995 S COBB DR SE
Second Line :
City : SMYRNA
State : GA
Zip : 30080-6342
Country : US
Telephone Number : 770-434-4567
Fax Number : 770-431-7045
Provider Business Practice Location Address
First Line : 3995 S COBB DR SE
Second Line :
City : SMYRNA
State : GA
Zip : 30080-6342
Country : US
Telephone Number : 770-434-4567
Fax Number : 770-431-7045
Authorized Official
Title or Position : CFO
Name : MRS. MONICA TIPPETT
Credential :
Telephone Number : 770-434-4568
Provider Enumeration Date : 06/01/2005
Last Update Date : 07/16/2007

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Directions to “RIDGEVIEW INSTITUTE,INC ” Practice Location

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