National Provider Identifier Database

SCOTTISH RITE CHILDRENS MEDICAL CTR
Children


Contact Information

SCOTTISH RITE CHILDRENS MEDICAL CTR
1001 JOHNSON FERRY RD NE
ATLANTA, GA30342-1605
Phone: 404-785-5252
Fax:
Website:
Specialty Taxonomy Code
* Children 282NC2000X

* Indicates primary specialty

NPI Profile & details for SCOTTISH RITE CHILDRENS MEDICAL CTR

NPI Number 1922178789
Legal business name
LBN
SCOTTISH RITE CHILDRENS MEDICAL CTR
Authorized official LOUETTA CODY - (MGR, PROVIDER ENROLLMENT)
Entity Organization
Organization subpart No
Enumeration date 11/09/2006
Last updated 02/23/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: 060-303
  • GA Medicaid: 000001636A
  • GA Other: 1000062 AMERIGROUP PROVIDER ID
  • GA Other: 000001636A PEACH STATE PROVIDER ID
  • GA Other: 21316 WELLCARE PROVIDER ID

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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