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Contact Information

CARDIOLOGY CARE CLINIC, LLC
119 HARMONY XING STE 3
EATONTON, GA31024-9571
 Phone: 706-485-4004
 Fax: 706-262-2986
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Rehabilitation: Cardiac Facilities

261QR0404X
Indicates primary specialty

NPI Profile & details for CARDIOLOGY CARE CLINIC, LLC

NPI Number 1962764639
LBN Legal business name CARDIOLOGY CARE CLINIC, LLC
Authorized official NICOLAS CHRONOS - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/08/2012
Last updated 07/27/2020 - About 6 years ago
Identifiers
GA Medicaid 003126643A
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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