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Contact Information

WELLSTAR PROFESSIONAL SERVICES, LLC
805 SANDY PLAINS RD
WPG-CBO
MARIETTA, GA30066-6340
 Phone: 770-792-5278
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
 

Infectious Disease

207RI0200X 11 Physician/Internal Medicine
 

Pediatric Cardiology

2080P0202X 37 Physician/Pediatric Medicine
 

Vascular Surgery

2086S0129X 76 Physician/Peripheral Vascular Disease
Indicates primary specialty

NPI Profile & details for WELLSTAR PROFESSIONAL SERVICES, LLC

NPI Number 1518139195
LBN Legal business name WELLSTAR PROFESSIONAL SERVICES, LLC
Authorized official NICOLE ASHE - (EXECTUIVE DIRECTOR OF FINANCE)
Entity Organization
Organization subpart 1 Yes
Enumeration date 03/24/2008
Last updated 07/14/2008 - About 18 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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