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Contact Information

POLARIS MEDICAL GROUP LLC
1136 CLEVELAND AVE
ATLANTA, GA30344
 Phone: 404-766-8110
 Fax: 404-766-8106
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for POLARIS MEDICAL GROUP LLC

NPI # 1366583577
LBN Legal business name POLARIS MEDICAL GROUP LLC
Authorized official LISA PERRY-GILKES - (CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 02/09/2007
Last updated 04/03/2009 - About 17 years ago
Identifiers
GA License # 052218
GA Medicaid 442333125C
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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