National Provider Identifier Database

MEDPRIME BROOKHAVEN
Preferred Provider Organization

A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.


Contact Information

MEDPRIME BROOKHAVEN
2 CONCOURSE PKWY
SUITE 100
ATLANTA, GA30328-5371
Phone: 678-691-8239
Fax:
Website:
Specialty Taxonomy Code
* Preferred Provider Organization 305R00000X

* Indicates primary specialty

NPI Profile & details for MEDPRIME BROOKHAVEN

NPI Number 1205288164
Legal business name
LBN
MEDPRIME BROOKHAVEN
Authorized official SHERWIN BRYANT - (COMPLIANCE OFFICER)
Entity Organization
Organization subpart No
Enumeration date 07/04/2016
Last updated 07/04/2016 - About 10 years ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: 61430

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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