National Provider Identifier Database

CARDIOLOGY CARE CLINIC LLC
Rehabilitation: Cardiac Facilities


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
* Rehabilitation: Cardiac Facilities 261QR0404X

* Indicates primary specialty

NPI Profile & details for CARDIOLOGY CARE CLINIC, LLC

NPI Number 1902452774
Legal business name
LBN
CARDIOLOGY CARE CLINIC, LLC
Authorized official NICOLAS CHRONOS - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 08/16/2019
Last updated 07/27/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • GA Medicaid: 000840364Q

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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