Prime Healthcare Foundation - Southern Regional, LLC

NPI #1679946669 in Riverdale, Georgia

Provider Information

NPI Number: 1679946669
Entity Type: Organization
Organization Name: Prime Healthcare Foundation - Southern Regional, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: PRIME HEALTHCARE FOUNDATION - SOUTHERN REGIONAL, LLC
Primary Specialty: Rehabilitation Unit
Enumeration Date: Nov 12, 2015
Last Updated: Nov 12, 2015

Practice Location

Address: 11 UPPER RIVERDALE RD SW
City: Riverdale
State: Georgia
ZIP Code: 30274-2615
Phone: (770) 991-8000

Authorized Official

Name: CHRISTOPHER DOAN
Title: CHIEF COMPLIANCE COUNSEL
Phone: (909) 235-4307

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Rehabilitation Unit	273Y00000X	Primary

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