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Contact Information

HOMETOWN PEDIATRICS LLC
108 N 4TH ST
VIENNA, GA31092-1115
 Phone: 229-231-5008
 Fax: 229-231-5539
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical Specialty

261QM2500X
Indicates primary specialty

NPI Profile & details for HOMETOWN PEDIATRICS LLC

NPI # 1013623263
LBN Legal business name HOMETOWN PEDIATRICS LLC
Authorized official HALEY PULLEN - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 01/30/2023
Last updated 01/30/2023 - About 3 years ago
Identifiers
GA Medicaid 1932748894
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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