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NPI Code Detail

MEDICARE: CLINICAL SUPPORT SERVICES,INC

MEDICARE: CLINICAL SUPPORT 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
1261QH0100XHealth Service Clinic/Center

Other Identifiers

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

General Provider Information

NPI Number : 1699863472
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLINICAL SUPPORT SERVICES,INC
Provider Business Mailing Address
First Line : 1900 THE EXCHANGE SE
Second Line : STE 390
City : ATLANTA
State : GA
Zip : 30339-2022
Country : US
Telephone Number : 770-916-1848
Fax Number : 770-988-8958
Provider Business Practice Location Address
First Line : 1900 THE EXCHANGE SE
Second Line : STE 390
City : ATLANTA
State : GA
Zip : 30339-2022
Country : US
Telephone Number : 770-916-1848
Fax Number : 770-988-8958
Authorized Official
Title or Position : PRESIDENT
Name : MR. MARION MAXWELL FITZGERALD
Credential :
Telephone Number : 770-916-1848
Provider Enumeration Date : 10/10/2006
Last Update Date : 08/22/2020

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Directions to “CLINICAL SUPPORT SERVICES,INC ” Practice Location

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