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Contact Information

GREENLINE MEDICAL CORPORATION
804 BOMBAY LN
ROSWELL, GA30076-5819
 Phone: 770-754-9880
 Fax: 770-754-9881
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
 

Pain Medicine

208VP0000X 72 Physician/Pain Management
Indicates primary specialty

NPI Profile & details for GREENLINE MEDICAL CORPORATION

NPI # 1073810453
LBN Legal business name GREENLINE MEDICAL CORPORATION
Authorized official KIMBERLY GREEN - (PHYSICIAN)
Entity Organization
Organization subpart 1 No
Enumeration date 02/19/2011
Last updated 02/19/2011 - About 15 years ago
Identifiers
GA License # 058478
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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