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NPI Code Detail

MEDICARE: CARDIOLOGY CARE CLINIC, LLC

MEDICARE: CARDIOLOGY CARE CLINIC, LLC
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
11041C0700XClinical Social Worker
2261QR0404XCardiac Rehabilitation Clinic/Center
3207RC0000XCardiovascular Disease Physician

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 : 1962764639
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARDIOLOGY CARE CLINIC, LLC
Provider Business Mailing Address
First Line : 119 HARMONY XING STE 3
Second Line :
City : EATONTON
State : GA
Zip : 31024-9571
Country : US
Telephone Number : 706-485-4004
Fax Number : 706-292-2986
Provider Business Practice Location Address
First Line : 119 HARMONY XING STE 3
Second Line :
City : EATONTON
State : GA
Zip : 31024-9571
Country : US
Telephone Number : 706-485-4004
Fax Number : 706-262-2986
Authorized Official
Title or Position : OWNER
Name : NICOLAS A.F. CHRONOS
Credential : MD
Telephone Number : 706-485-4004
Provider Enumeration Date : 06/08/2012
Last Update Date : 07/27/2020

Similar Medicare Providers

1427057165 — NICOLAS A.F. CHRONOS MD
Practice Location Address:
119 HARMONY XING STE 3
EATONTON, GA
31024-9571
Practice Phone: 706-485-4004
Practice Fax: 706-262-2986
1992754519 — ERIC K SILVER MD
Practice Location Address:
119 HARMONY XING STE 3
EATONTON, GA
31024-9571
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1891744298 — PETER D CHAPMAN MD
Practice Location Address:
119 HARMONY XING STE 3
EATONTON, GA
31024-9571
Practice Phone: 706-484-4004
Practice Fax: 706-262-2986
1740310044 — DIANE PETERMAN MD
Practice Location Address:
119 HARMONY XING STE 3
EATONTON, GA
31024-9571
Practice Phone: 706-485-4004
Practice Fax:
1114154077 — CARY AUSTIN SANDERS HEFTY M.D.
Practice Location Address:
119 HARMONY XING STE 3
EATONTON, GA
31024-9571
Practice Phone: 706-485-4004
Practice Fax: 706-262-2986
1932408440 — CRISTINA EVANS BREHOB PA-C
Practice Location Address:
119 HARMONY XING STE 3
EATONTON, GA
31024-9571
Practice Phone: 706-485-4004
Practice Fax: 706-262-2986

Directions to “CARDIOLOGY CARE CLINIC, LLC ” Practice Location

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