Provider Demographics
NPI:1083974265
Name:SYSTEMS RESEARCH AND APPLICATIONS
Entity Type:Organization
Organization Name:SYSTEMS RESEARCH AND APPLICATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-577-2266
Mailing Address - Street 1:1250 TYNECASTLE WAY
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-3516
Mailing Address - Country:US
Mailing Address - Phone:260-577-2266
Mailing Address - Fax:
Practice Address - Street 1:1250 TYNECASTLE WAY
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30350-3516
Practice Address - Country:US
Practice Address - Phone:260-577-2266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health