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Contact Information

CENTERWELL SENIOR PRIMARY CARE GA PC
3245 LAWRENCEVILLE SUWANEE RD # 100
SUWANEE, GA30024-6541
 Phone: 770-341-9135
 Fax: 770-545-6599
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
 

Non-Pharmacy Dispensing Site

332900000X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for CENTERWELL SENIOR PRIMARY CARE GA PC

NPI Number 1154148526
LBN Legal business name CENTERWELL SENIOR PRIMARY CARE GA PC
Authorized official ANGIE MARTINEZ - (SENIOR CREDENTIALING PROFESSIONAL)
Entity Organization
Organization subpart 1 Yes
Enumeration date 09/25/2024
Last updated 01/24/2025 - More than a year 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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